Understanding Chalazion: Causes, Symptoms, and Treatment Options

Understanding Chalazion and Chalazion Surgery

A chalazion is a lump that develops on the eyelid due to a blocked oil gland. Chalazia (plural for chalazion) are typically painless and often go away on their own. However, in some cases, a chalazion may require surgery for removal. This article provides an overview of chalazion causes, symptoms, diagnosis, and surgical treatment options.

What Is a Chalazion?

A chalazion (also spelled chalazium) is a firm, round bump that forms on the eyelid due to obstruction of an oil gland. The medical term for this condition is internal hordeolum. Chalazia are typically painless, slow-growing bumps that develop gradually over a few weeks or months.

Chalazia occur when an oil gland within the eyelid becomes blocked. There are numerous small oil glands within the upper and lower eyelids that produce an oily substance called meibum. This helps lubricate the eye. If one of these glands becomes obstructed due to thickening of the meibum, the gland and duct may swell up, forming a chalazion.

Causes and Risk Factors

There are a few potential causes and risk factors for chalazion development, including:

• Inflammation or infection of the oil gland
• Blepharitis (eyelid inflammation)
• Rosacea
• Seborrheic dermatitis
• Acne
• Stress
• Poor lid hygiene
• Exposure to irritants like makeup, oils, or lotions

In many cases, chronic inflammation around the eyelid oil glands leads to blockage and chalazion formation. Infection is another cause, typically due to the bacteria Staphylococcus aureus. Those with chronic skin conditions like blepharitis, rosacea, and seborrheic dermatitis have a higher risk of developing chalazia.

Signs and Symptoms

The most common signs and symptoms of a chalazion include:

• A round, firm bump on the upper or lower eyelid
• Slight swelling and reddening of the eyelid
• Mild eyelid tenderness in some cases
• Heaviness of the eyelid
• Blurry vision if the chalazion is large

Chalazia range in size from small, pea-sized lumps to larger nodules around 1 centimeter across. They are typically dome-shaped with distinct borders. The overlying skin retains its normal color.

Chalazia tend to develop slowly and are not very painful. Unlike styes which are infected eyelid bumps, chalazia are usually painless. However, some mild tenderness and discomfort may occur if the chalazion puts pressure on the eyeball.

Diagnosing a Chalazion

An ophthalmologist or optometrist can diagnose a chalazion through a slit lamp exam of the eyelid. The slit lamp allows magnified visualization of the eyelid structures.

The doctor will look for the characteristic firm, dome-shaped bump along the eyelid margin. Gentle pressure with a finger can confirm the firmness of a chalazion. Doctors may also check for tenderness by gently manipulating the eyelid.

To rule out other possible causes, the doctor may perform additional tests. These include:

• Swabbing the eyelid for bacterial culture
• Measuring eyelid thickness
• Testing eyelid mobility
• Everting the eyelid to examine the conjunctiva

If an internal chalazion is suspected, the doctor may order an incisional biopsy. This involves numbing the eyelid, making a small cut, and removing a tiny piece of the lesion for analysis. Examining the biopsy sample under a microscope can help confirm the diagnosis.

Chalazion Treatment and Surgery

Many small chalazia resolve on their own within a few months and may not require treatment. However, there are some treatment options for stubborn chalazia:

• Warm compresses - Applying a warm, clean washcloth to the affected eyelid for 10-15 minutes a few times per day can help improve drainage and healing.
• Eyelid Scrubs - Gently scrubbing the eyelid margins using diluted baby shampoo may help reduce oil buildup.
• Antibiotic ointment - If bacterial infection is suspected, an antibiotic ointment may be prescribed.
• Steroid injections - A steroid like cortisone can be injected directly into the chalazion to reduce inflammation and promote drainage.
• Incision and curettage - A small incision is made in the back of the eyelid to drain the clogged gland contents. The doctor then scrapes the lining of the cyst wall (curettage).
• Chalazion excision surgery - In severe cases, the entire chalazion may be surgically removed.

Chalazion Surgery Procedures

If a chalazion does not respond to more conservative treatments, a surgery will likely be required. There are two main types of surgery for chalazion removal:

1. Incision and Curettage - This is the most common procedure. It involves making a small incision on the back side of the eyelid at the chalazion site. The contents of the cyst are then drained out. Next, the doctor thoroughly scrapes the inner walls of the cyst cavity to remove any remaining clogged material. The incision is left open to allow further drainage. It usually heals on its own within a few days.
2. Excision - In some cases, the entire chalazion lesion may be excised (cut out). This requires an incision into the conjunctiva (clear membrane) on the inside of the eyelid. The chalazion is removed entirely and the incision closed with stitches. Excision may be done if the chalazion returns after incision and curettage.

Both procedures are typically performed under local anesthesia. This involves injecting a numbing medication like lidocaine around the eyelid and chalazion. The anesthesia blocks pain during the procedure.

The Chalazion Surgery Procedure Step-by-Step

If you are having a chalazion removed surgically, here is a general overview of what to expect during the procedure:

1. You will lie down on an exam chair or operating table. The eye area will be cleaned and prepped.
2. Local anesthetic will be injected with a tiny needle into the eyelid around the chalazion. This will numb the area within about 5 minutes.
3. For incision and curettage: The doctor will use a small scalpel or blade to make a tiny incision on the back outer surface of the eyelid near the chalazion. Drainage of the cyst contents will be promoted.
4. A special instrument called a curette will be inserted through the incision. The doctor will use this to gently scrape the inside of the cyst cavity and remove any remaining clogged material.
5. The incision will be left open to drain. A bandage and antibiotic ointment may be applied.
6. For excision: An incision will be made through the conjunctiva on the inner eyelid. The chalazion will be completely cut out and removed. Stitches will close the incision.
7. The procedure takes around 10-15 minutes depending on the technique. Monitoring in a recovery area follows before you are discharged.
8. Full recovery takes around 1-2 weeks. The doctor will provide post-op wound care instructions.

Recovery After Chalazion Surgery

Following your chalazion removal, you can expect:

• Mild pain and swelling around the eyelid for the first 24-48 hours. Over-the-counter pain medication may help.
• Redness, bruising, and drainage at the incision site as it starts healing.
• Antibiotic ointment and eyelid massage may be recommended for wound care.
• Stitches will dissolve on their own within a week if they were used.
• Avoid rubbing or irritating the operated eyelid during the healing process.
• Normal activities can usually be resumed within 2-3 days.
• Full recovery takes around 1-2 weeks in most cases.

Promptly contact your eye doctor if you experience excessive pain, vision changes, bleeding, fever, or drainage after chalazion surgery. These could signal potential complications like infection.

Results and Outlook After Chalazion Surgery

Most people experience an excellent outcome after chalazion surgery. The unsightly eyelid bump is removed and normal eyelid appearance and function restored. Recurrence rates are low, around 3-4% of cases.

If a chalazion does return after surgery, repeat treatment may be needed. This could involve further steroid injections, incision/curettage, or excision procedures. Consistently performing warm compresses and eyelid hygiene helps minimize recurrence risk.

While complications are rare with chalazion surgery, potential side effects can include:

• Reformation of the chalazion
• Eyelid scarring
• Eyelid notch (from larger excisions)
• Wound infection
• Bleeding
• Eyelid swelling or redness
• Blurry or reduced vision

Following all post-op care instructions can help reduce complication risks. Contact your ophthalmologist promptly if you have any concerns after surgery.

Preventing Chalazia

You may be able to reduce your risk of developing chalazia by:

• Performing daily warm compresses and eyelid scrubs
• Gently massaging the eyelids to promote gland drainage
• Using antibiotic ointment at the first sign of eyelid redness or swelling
• Avoiding makeup and cosmetics around the eyes
• Treating conditions like blepharitis, rosacea, and seborrheic dermatitis
• Protecting the eyes from irritants like smog, chlorine, hairspray
• Practicing good hygiene and not touching the eyes with unclean hands
• Getting chalazia treated promptly before they enlarge

People with recurring chalazia may need ongoing treatment and monitoring to prevent new lesions from developing.

Key Takeaways

• A chalazion results from a blocked Meibomian gland along the eyelid margin.
• Chalazia are typically painless, slow-growing bumps that may heal on their own.
• Treatment options range from warm compresses to steroid injections or surgery.
• Surgery by incision/curettage or excision successfully removes the lesion in most cases.
• Following post-op wound care instructions can promote proper healing.
• Good eyelid hygiene helps prevent recurrence of chalazia.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.