Chalazion

👁️‍🗨️ Chalazion

🔍 Definition

A chalazion is a chronic, painless, non-infectious granulomatous inflammation of the meibomian gland, caused by blockage and retention of meibum.

🔄 It's basically a firm lump in the eyelid due to gland obstruction, not infection like a stye.

 

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🧬 Etiology / Pathophysiology

• Meibomian gland gets blocked → lipid secretions (meibum) build up

• Triggers a granulomatous inflammatory response

• Eventually forms a firm, well-circumscribed nodule in the tarsal plate

🔍 Chronic cases show lipogranuloma on histology.

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👁️ Key Features: Chalazion vs. Stye

Feature	Chalazion	Stye (Hordeolum)
Cause	Blocked meibomian gland (non-infectious)	Acute staph infection (Zeis or meibomian)
Onset	Gradual	Sudden, acute
Pain	Usually painless	Painful, tender
Location	Inner eyelid (tarsal plate)	Margin of eyelid (external or internal)
Appearance	Firm, round lump	Red, tender swelling
Treatment	Often conservative or surgical if chronic	Warm compresses, antibiotics if needed

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👀 Symptoms

• Painless eyelid swelling or lump

• Heaviness in the eyelid

• Cosmetic concern

• May cause blurred vision if large (pressure on cornea)

• Occasionally mild tenderness (esp. early phase)

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🔬 Signs on Examination

• Firm, round, immobile nodule in the tarsal plate

• No redness or pus (unless secondarily infected)

• Overlying skin moves freely

• May be visible through the conjunctiva if turned inside out

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💊 Management

🔹 Conservative Treatment (First Line)

Step	Details
Warm compresses	10–15 min, 3–4x/day to liquefy and drain meibum
Gentle massage	Toward lid margin after warm compress
Lid hygiene	Prevents recurrence
Monitor	Many resolve within 2–6 weeks

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🔹 Medical Treatment (If Inflammation or Recurrent)

• Topical antibiotics/steroids: e.g., Tobradex (combo drops)

• Not effective alone for chronic chalazion but may help early on

• Intralesional steroid injection (e.g., triamcinolone) for persistent cases

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🔹 Surgical Treatment (If Conservative Fails)

Treatment	Notes
Incision and curettage (I&C)	Simple procedure under local anesthesia
Excision biopsy (if atypical)	Rule out sebaceous gland carcinoma if recurrent or suspicious in elderly

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⚠️ Complications

• Astigmatism (from pressure on cornea)

• Secondary infection (becomes stye-like)

• Cosmetic disfigurement

• Recurrent chalazia → consider sebaceous gland carcinoma if atypical

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🧠 Mnemonic: CHALAZION

Chronic
Hard lump
Asymptomatic (usually)
Lid nodule
Affects meibomian gland
Zero pain (mostly)
Incision if persistent
Oil trapped (blocked duct)
Non-infectious

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📋 Quick Snapshot

Feature	Chalazion
Onset	Gradual
Pain	Usually none
Gland involved	Meibomian
Treatment	Warm compress, I&C if needed
Antibiotics?	Not usually required
When to biopsy	If recurrent, atypical, older patient

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📌 Patient Tips

• Don’t squeeze the lump!

• Stick to warm compresses daily

• Practice lid hygiene long-term (especially if prone to blepharitis or MGD)

• Wear sunglasses outdoors to reduce irritation

• Consult ophthalmology if it doesn’t resolve in 1–2 months

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Would you like:

• A visual diagram of chalazion formation and treatment?

• A printable comparison chart of stye vs chalazion?

• A short video-style script explaining it in patient-friendly terms