The chalazion explained by Dr. Alex Shortt

What is a chalazion?

A chalazion is a very common eyelid problem and it is basically a very large lump in the eyelid. It tends to be deep within the eyelid because it's caused by a blockage of one of the main oil glands called the meibomian gland which is deep within the eyelid. You will know you have a chalazion because you will get pain, swelling of the eyelid, and it will be very sore to touch and the whole eyelid can swell quite a lot in the acute or the early stage of a chalazion. What tends to happen is that even with treatment with antibiotics or anti-inflammatories, the chalazion will reduce slowly reduce in size and the eyelid will become less swollen but many people after the acute phase of a chalazion will be left with still a lump or a cyst within the eyelid which will then need to have an operation to drain.

How do you differentiate a chalazion from a stye?

A stye is a blockage of one of the hair follicles on the front surface of the eyelid. A stye tends to be a small white spot or lump on the very front surface of the eyelid. A chalazion is different because it is the blockage of an oil gland much deeper in the eyelid. A chalazion will present as a much deeper swelling and a larger swelling, and you will not be able to see a white spot on the front surface of the eyelid. A stye tends to improve very quickly with some mild antibiotic treatment to the area of the spot. It can also be helped by plucking the eyelash or squeezing the spot to help it discharge. A chalazion tends to take a lot longer to improve and normally needs some treatment with antibiotics, either tablets or ointment, and sometimes it may even need an operation if there is a persistent cyst or swelling.

How do you treat a chalazion?

The treatment of a chalazion depends on the stage of the condition. Early on, when a chalazion first develops, the eyelid is very very swollen and inflamed. The treatment in this stage is to reduce the inflammation and to treat any infection, so antibiotics and anti-inflammatories are important in this stage of the condition. Later on, when the inflammation and the redness and the soreness has reduced, you can be left with a cyst or a large swelling deep in the eyelid. At this stage we recommend people to apply heat to the eyelid after to try to compress or squeeze the cyst so that it bursts or discharges. If this is not successful and there are still a large visible lump in the eyelid then you will need an operation to drain this system.

What should I do if I have a chalazion?

If you have a chalazion, or if you think you have a chalazion, it is important to seek the advice of an ophthalmologist. The reason is that in the early stage of a chalazion, the acute chalazion stage, the eyelid can actually be infected or the blocked gland that causes the chalazion may have an infection. So it is important to determine whether or not you need antibiotic treatment. You should use anti- inflammatory treatment to reduce the swelling and the pain. Once the acute swelling and inflammation is gone, you may or may not have a residual cyst or lump in the eyelid. If you do then your ophthalmologist will need to perform a minor procedure to drain this cyst.

What precautions should be taken?

If you have developed a chalazion then it's very likely that you have a condition called blepharitis. Blepharitis is the condition where there's inflammation of the edge of the eyelid which makes the oil glands in the eyelid more prone to blocking and becoming inflamed and infected. It’s important you see your ophthalmologist to be checked for blepharitis and to have any treatment if required. If you are suffering from recurrent chalazia which is basically a chalazion which then resolves but then you develop another one either in the same place or in a different place then it's very important that again you're checked for blepharitis and as possible you will need some ongoing treatment to prevent the development of chalazia over and over again.

How do you prevent chalazia?

If you are getting more and more chalazia, so you're having multiple chalazia then it's very likely that you have blepharitis and particularly posterior blepharitis. If this is the case, you need to see your ophthalmologist and to investigate whether treatment is required to prevent chalazia developping in a recurrent way. Your ophthalmologist is very likely to recommend that you use lid hygiene wipes to remove the debris, the dead skin, and the buildup of oil from the edge of the eyelids and a particular wipes such as Blephaclean® wipes or Blephasol® solution are very effective and safe ways of doing this. Another treatment which can help very significantly with posterior blepharitis and recurrent chalazia is the Blephasteam® device. This is a method of delivering the right amount of heat and warming to the eyelids to melt the oil and help it to flow more freely within the eyelids and the eyelid glands. The last thing we can do if you have blepharitis and recurrent chalazia is to use a good quality lubricant to reduce the amount of inflammation and irritation on the surface of the eye. Probably the best lubricant I found in clinical practice is the Thealoz® Duo which combines two effective lubricants to prevent damage and inflammation on the surface of the eye as a result of Blepharitis.