Chalazion

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Chalazion
Classification and external resources
Eyelid affected by Chalazion
ICD-10 H00.1
ICD-9 373.2
DiseasesDB 6009
MedlinePlus 001006
eMedicine emerg/94  oph/243
MeSH D017043

A chalazion /kəˈleˌzi.ən/ (plural chalazia /kəˈleˌzi.ə/), also known as a meibomian gland lipogranuloma, is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. Chalazions differ from styes (hordeolums) in that they are usually painless apart from the tenderness caused when they swell up, and in size (chalazia tend to be larger than styes). A chalazion may eventually disappear on its own after a few months, though more often than not, some treatment is necessary.

Contents

[edit] Signs and symptoms

  • Swelling on the eyelid
  • Eyelid tenderness
  • Sensitivity to light
  • Increased tearing
  • Heaviness of the eyelid

[edit] Treatment

A large chalazion ca. 20 minutes upon excision. This bipartite chalazion was removed via two separate incisions. Further along the lower eyelid, signs of chronic inflammation (Blepharitis) are visible.
A large chalazion ca. 20 minutes upon excision. This bipartite chalazion was removed via two separate incisions. Further along the lower eyelid, signs of chronic inflammation (Blepharitis) are visible.

The primary treatment is application of warm compresses for 10 to 20 minutes at least 4 times a day. This may soften the hardened oils blocking the duct and promote drainage and healing.

Topical antibiotic eye drops or ointment (eg chloramphenicol or fusidic acid) are sometimes used for the initial acute infection, but are otherwise of little value in treating a chalazion. Chalazia will often disappear without further treatment within a few months and virtually all will resorb within two years.[1]

If they continue to enlarge or fail to settle within a few months, then smaller lesions may be injected with a corticosteroid or larger ones may be surgically removed using local anesthesia.[2][3] This is usually done from underneath the eyelid to avoid a scar on the skin. If the chalazion is located directly under the eyelid's outer tissue, however, an excision from above may be more advisable so as not to inflict any unnecessary damage on the lid itself. Eyelid epidermis usually mends well, without leaving any visible traces of cicatrisation.[4] Depending on the chalazion's texture, the excision procedure varies: while fluid matter can easily be removed under minimal invasivion, by merely puncturing the chalazion and exerting pressure upon the surrounding tissue, hardened matter usually necessitates a larger incision, through which it can be scraped out. Any residual matter should be metabolized in the course of the subsequent healing process, generally aided by regular appliance of dry heat. The excision of larger chalazia may result in visible hematoma around the lid, which will wear off within three or four days, whereas the swelling may persist for longer. Chalazion excision is an ambulant treatment and normally does not take longer than fifteen minutes. Nevertheless, owing to the risks of infection and severe damage to the eyelid, such procedures should only be performed by a doctor.

Rarely chalazia may recur and these will be biopsied to help rule out tumors.

[edit] Complications

A large chalazion can cause astigmatism due to pressure on the cornea. This will resolve with resolution of the chalazion.

Complications including, but not limited to hypopigmentation may occur with corticosteroid injection.

The presence of recurring chalazion in the same area sometimes leads to a consideration of sebaceous cell carcinoma.

The minor operation is quite painless, the eyelid is injected with a local anesthetic a clamp is put on the eyelid, then the eyelid is turned over and the chalazion is scraped out.


[edit] See also

[edit] References

  • (1994) in J.B. Lippincott: The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Ocular Disease. 
  1. ^ Chalazion 2080768019 at GPnotebook
  2. ^ Khurana A, Ahluwalia B, Rajan C (1988). "Chalazion therapy. Intralesional steroids versus incision and curettage". Acta Ophthalmol (Copenh) 66 (3): 352-4. PMID 10994460. 
  3. ^ Jackson T, Beun L (2000). "A prospective study of cost, patient satisfaction, and outcome of treatment of chalazion by medical and nursing staff". Br J Ophthalmol 84 (7): 782-5. doi:10.1136/bjo.84.7.782. PMID 10873994.  — in which of those cases attending a District General Hospital, approximately one third of selected chalazia resolved within 3 months with conservative treatment, and surgical treatment was successful for 72%.
  4. ^ Gerstenkorn/Hagelkorn

[edit] External links