Chalazion

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Introduction

A chalazion is a firm, round, fluid-filled lump that is found in the upper or lower eyelid. It is also known as a meibomian cyst. These cysts vary in size, typically ranging from 2–8mm.

These cysts can occur when the eyelid glands (meibomian glands) which produce oils to help to keep the eyes moist become blocked.

A chalazion does not need any specific treatment as it tends to come and go on its own. However, it can take a few months to get better.

See your doctor if the chalazion becomes painful, red, warm, and swollen as it may be infected. He or she may prescribe antibiotics to prevent a deep eyelid infection.

Symptoms

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A painless lump on your upper or lower eyelid is the main symptom of a chalazion. It tends to develop slowly over several weeks. The lump can be as small as 2mm or as large as 8mm wide.

You may have several lumps at once, and one or both eyes may be affected.

While a chalazion tends to be painless, it can cause mild, but temporary, discomfort, especially when it is just starting to develop.

On rare occasions, a chalazion can become infected. If this happens, you may notice that the lump becomes bigger, red, and painful.

A larger chalazion can press on the eyeball and affect your vision.

Causes

There isn’t always an obvious cause of chalazion – the lump often develops on its own. However, it can develop after a stye (minor infection of the base of an eyelash) or when the meibomian glands aren’t functioning as they should. It tends to develop slowly over several weeks.

There are some conditions that can increase your risk of developing a chalazion. These include:

Diagnosis

Your doctor may suspect you have a chalazion after asking you questions about your symptoms, lifestyle, eye health, general health, medical history, and family history of diseases.

Your doctor may examine your eyes, which could involve pulling down your lower eyelid or turning up your upper eyelid a little to take a closer look at the chalazion.

Your doctor may refer you to an eye specialist (ophthalmologist) if:

  • your chalazion has been there for a long time
  • it keeps recurring
  • it is very large
  • it is making contact with your eyeball

Treatment

Most chalazia resolve on their own over several weeks or months, and require no specific treatment.

However, if you are experiencing discomfort, a few measures may provide some relief. These include:

  • closing the affected eye and applying a warm compress (a clean flannel that has been in warm - not scalding - water) against it for 5–10 minutes. The warmth and pressure can help to soften the contents of the chalazion and help it drain more easily
  • massaging the chalazion after using a warm compress can encourage it to drain. You can do this by using a clean finger or cotton bud to gently rub the cyst in the direction of the eyelashes
  • cleaning the eyelid twice a day (if there is associated blepharitis), using a weak solution of baby shampoo in warm water, can help to remove the grease and dead skin cells that may encourage a chalazion to form

If the chalazion does not settle on its own, your doctor may refer you to an ophthalmologist who may recommend a steroid injection or chalazion surgery. The surgery is a minor procedure in which the eye is numbed and a small cut is made inside the eyelid to drain the contents of the chalazion.

Outlook

In the majority of cases, a chalazion is a one-off condition that resolves on its own without causing any complications. However, it can take several weeks or months to resolve and, for some, it can recur.

You can reduce the risk of a chalazion coming back by using a warm compress and then massaging your eyelids every morning. This will help to keep the meibomian glands from getting blocked and prevent a chalazion from forming.

Complications

Most of the time, a chalazion will come and go on its own without causing any problems. However, in rare cases, it can cause complications. These may include:

  • visual problems – larger chalazia can rub against the eyeball and affect your vision. If this happens your doctor may refer you to an ophthalmologist for treatment
  • infection – sometimes a chalazion can become infected. When this happens, the eye usually becomes more painful and red. If you notice these symptoms, see your doctor immediately as you may need antibiotics to treat the infection
  • orbital cellulitis (an infection of the fat and muscles around the eye) - this is a rare complication. It can be very painful and can cause double or blurred vision and also a high temperature. See your doctor immediately as orbital cellulitis needs urgent treatment
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