Chalazion

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 3, 2016
StartDiseasesChalazion

A chalazion is also known as a meibomian gland lipogranuloma or meibomian cyst. Chalazia are benign, painless, and slowly developing bumps in the eyelid. They are most commonly formed on the underside of the upper eyelid, but they may also form on the inside of the lower eyelid.  

Contents

Definition & Facts

Chalazia are formed by the thickening of natural fluids in the meibomian oil glands within the eyelid. The cyst that forms is caused by an inflammation of the glands. Chalazia are typically not caused by an infection, and are not painful. Adults aged 30-50 most commonly report chalazia. They can occur in children but this is less common.

They are sometimes mistaken for a stye. Both styes and chalazia are bumps or cysts that develop in or on the eyelid. A stye is caused by an infection in an oil gland, and it usually is a painful bump that has developed on the edge or exterior portion of the eyelid. A chalazion is not usually painful or infectious.

Symptoms & Complaints

Individuals with a chalazion experience swelling in the eyelid that develops into a firm bump that may become larger and more prominent. It commonly lasts for an extended period of time, and creates excessive amounts of tearing (epiphora) and irritation.

The tearing is the result of the lump creating an obstruction, and this obstruction then hinders the tear ducts' ability to drain properly. The lump may initially present as tender, but it commonly calms and becomes painless.

Blurred vision may also be experienced, as the hard, firm lump applies unwanted pressure on the eyeball. Sensitivity to bright lighting may occur and contribute to excessive amounts of irritation and tearing.

Heaviness is increased in the eyelid, as the lump grows more inflamed. This heaviness may hinder the ability for the eyelid to fully open, and can obstruct vision. Chalazia may eventually become cosmetically distracting and unappealing.

Infection is not a common symptom, but may occur in which case the chalazion may be described as a stye. It can be filled with pus and fatty secretions. An inflamed eye or eyelid should be seen immediately by an eye doctor.

Causes

Chalazia are the most common type of eyelid cyst. They are caused by a clogged gland, which may be the result of dirt or debris from makeup or allergens. Excessive eye makeup may be linked to the clogging of the eye glands. Oily eye makeup removers may also be a factor in the development of a stye or chalazion. 

Chalazia can also develop as a component of another illness. Individuals with other health conditions or the eye condition, blepharitis are more susceptible to developing one or more chalazia. Blepharitis is an inflammatory condition that may improve with proper hygiene. It is the repetitive inflammation of the meibomian gland that is caused by a meibomian gland dysfunction. Rosacea or eczema may also be contributing factors in the formation of chalazia.

Some individuals may be more susceptible to chalazia. Chalazia may spontaneously appear and they may be resolved suddenly, either with treatment or on their own. Risk factors for developing chronic chalazia include the following conditions:

Diagnosis & Tests 

A visit to an eye doctor will include an eye examination. If the doctor suspects a chalazion is developing under the eyelid, he or she will turn up the eyelid to examine it underneath. This examination can be uncomfortable, but it proves to be a conclusive exam for diagnosing the formation or development of chalazia. 

Treatment & Therapy

Chalazia commonly drain gradually and disappear without treatment, and chalazia should not be squeezed or compressed in an attempt to drain them. This could cause further complications. Early treatments are recommended to help the fluids in the cyst drain. Possible treatments include:

  • Warm compresses should be applied multiple times daily to assist in loosening the lump’s hardened secretions.
  • Using clean fingers or a cotton swab, one can massage the lid in a gentle but firm circular motion in the direction of the lid’s edge.
  • Dipping the cotton swab in baby shampoo, and wiping the eyelid is recommended.
  • Antibiotics may be prescribed by the doctor, if necessary.

A person may request a surgical removal if they desire a rapid resolution. In addition, a persistent chalazion may require a minor surgical procedure which could be completed in the doctor's office and accompanied with antibiotics. Surgically cutting out the chalazion may be deemed necessary if it has grown large enough to cause visual problems or significant irritation. The eyelid will be inverted and clamped in place while the lump is surgically removed. 

Approximately 50 percent of chalazia resolve spontaneously or through the use of conservative treatment. They do not typically recur. Lesions that repeatedly return to the original site should be considered suspicious by the eye doctor and may be biopsied.

Prevention & Prophylaxis

The prevention of gland clogging is the best way to prevent the formation of a chalazion eyelid lump, and keeping the eyelids properly cleansed is an essential preventative approach against the development of chalazia.

Properly cleansing the eyelids should be completed daily. The avoidance of oily eye makeup and eye makeup removers may help prevent chalazia.

The short-term use of antibiotics may be temporarily prescribed by the eye doctor. The continued use of daily warm compresses and baby shampoo on a cotton swab may assist in the prevention of a future chalazion formation.

Keeping the eyes lubricated may enable tears to spread evenly on the front of the eye, and can assist in the proper drainage needed for gland health. Over-the-counter lubricants may be used to treat dry eyes and to keep the front of the eye properly lubricated. This may assist in preventing future chalazia.