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A chalazion pronounced /k?’le?zi?n/ (plural chalazia /k?’le?zi?/), 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.
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 (e.g. 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.
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.
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