OVERVIEW

What is a Chalazion?

A chalazion, also known as a meibomian cyst, is an idiopathic, sterile, chronic granulomatous inflammation of the meibomian glands. Unlike common suppurative inflammation, it does not present with typical symptoms like redness, swelling, heat, or pain. Instead, it involves a unique proliferative process characterized by granulomatous nodules formed by macrophage proliferation. It appears as a painless eyelid swelling.

In the early stages, warm compresses can be applied to the eyelid. If there is no sign of reduction after one month, an ophthalmologist may perform a cyst incision and drainage procedure.

What are Meibomian Glands?

Present in both the upper and lower eyelids, the meibomian glands appear as tiny, white, radial ducts on the inner surface of the eyelid when it is everted. Their openings can be seen along the eyelid margin. When these openings become blocked, small white spots may appear.

What is a Hordeolum (Stye)?

A hordeolum, commonly called a stye, is an acute suppurative inflammation of the eyelid glands. Most cases are caused by staphylococcal infections, with Staphylococcus aureus being the most frequent pathogen.

Which Department Treats Chalazion?

Ophthalmology.

SYMPTOMS

Is chalazion more common in the upper or lower eyelid?

Generally, it occurs more frequently in the upper eyelid, but it can also appear in the upper, lower eyelids, or both eyes simultaneously.

What symptoms does chalazion cause?

Larger lumps may cause visible eyelid swelling without pain. Some small cysts require careful palpation to detect—small nodules under the skin of the upper or lower eyelid, one or multiple, with clear boundaries when touched, slightly raised skin surface, and no redness or pain.

If the eyelid is flipped open, a localized dark red lesion area can be observed on the inner surface of the corresponding eyelid.

Why does a chalazion become increasingly painful? Is it infected?

Occasionally, this may happen. If pain occurs along with redness and swelling, it could indicate an infection.

Can chalazion affect vision? What harm does it cause to the eyes?

Generally, chalazion does not affect vision unless it grows excessively large and presses on the cornea, potentially inducing astigmatism and altering vision. Otherwise, as an eyelid issue, it poses no harm to the eyeball.

Can chalazion become malignant?

No, it does not turn malignant. However, in elderly individuals, it should be differentiated from sebaceous gland carcinoma. The distinction can only be confirmed through postoperative pathological diagnosis.

CAUSES

What is the cause of a chalazion?

It may be caused by obstruction of meibomian gland secretion. Alternatively, excessive glandular secretion in the eye or a deficiency of vitamin A can lead to hyperkeratosis of the secretory glandular epithelium, blocking the drainage pathway. This results in the retention of glandular secretions, causing chronic irritation to the surrounding tissues and eventually forming a sterile chronic granulomatous inflammation.

Who is more prone to chalazion?

It is more common in adolescents or middle-aged individuals, likely due to the heightened secretion of meibomian glands in this age group.

Is a chalazion contagious?

A chalazion is a sterile chronic granulomatous inflammation and is not contagious.

DIAGNOSIS

How should chalazion be diagnosed?

The diagnosis of chalazion mainly relies on typical symptoms, which is a clearly defined small lump on the eyelid, and this is usually sufficient for confirmation. For elderly individuals, it is important to differentiate it from meibomian gland carcinoma, but the distinction between the two can only be made through pathological diagnosis after surgery.

Which diseases have symptoms similar to chalazion?

Yes, the most similar condition is meibomian gland carcinoma. Additionally, stye (hordeolum) may also resemble chalazion in some manifestations.

How to distinguish between chalazion and meibomian gland carcinoma?

Symptomatically, it is difficult to differentiate between the two. Meibomian gland carcinoma is more common in women over 50 years old. For a definitive diagnosis, pathological examination of the excised tissue during incision and curettage drainage is usually required.

How to distinguish between chalazion and stye (hordeolum)?

Both conditions present as small lumps under the eyelid skin.

A stye is a purulent inflammation, usually accompanied by redness, swelling, heat, and pain, whereas a chalazion is a non-purulent inflammation and thus lacks pain and redness. However, distinguishing between an infected chalazion and a stye can be extremely challenging.

TREATMENT

How to treat chalazion?

In the early stage, you can apply warm compresses to the eyelids twice a day for about 20 minutes each time.

If the lump shows no signs of shrinking after a month, it is recommended to visit a hospital. An incision and curettage drainage procedure can be performed in the ophthalmology department. This is a minor outpatient surgery that does not require hospitalization, and antibiotic eye drops can be used postoperatively.

What happens if chalazion is left untreated?

Some small chalazia may resolve on their own, but most remain unchanged or gradually enlarge, becoming softer in texture. They may also rupture spontaneously, after which the lump may appear smaller or disappear. However, a mushroom-like granuloma may form on the inner surface of the eyelid.

What to do if a chalazion becomes infected?

An infected chalazion may cause localized eyelid swelling, pain, and other inflammatory reactions, making it difficult to distinguish from a stye. In such cases, the treatment principles and methods for both conditions are the same: topical antibiotic eye drops or ointments to control the infection.

Since the nature of a chalazion is a sterile granuloma, antibiotic eye products can only control the infection but cannot eliminate the chalazion. Therefore, surgical treatment is still required after the infection is under control.

When does a chalazion require surgery?

Generally, if the lump does not resolve or show signs of shrinking after a month, surgical treatment should be considered.

What preparations are needed before chalazion surgery?

No special preparation is required.

Can oral solutions or eye drops treat chalazion?

No. To date, surgery is the only effective treatment for cysts that do not resolve with warm compresses.

Will chalazion surgery affect appearance?

Chalazion surgery is typically performed on the inner surface of the eyelid, leaving no external scars and thus no impact on appearance.

Can chalazion recur after treatment?

It is possible for another chalazion to develop. However, this is not considered a recurrence but rather the formation of a new chalazion, as the eyelid has multiple gland ducts. If one becomes blocked, a chalazion forms.

Even if one chalazion is treated, other ducts may still become blocked, leading to the formation of another new chalazion.

Is follow-up with a doctor necessary after chalazion surgery?

Generally, no follow-up is needed unless there are special circumstances.

If a chalazion does not grow larger, is surgery still necessary?

Generally, surgery is still required, as a chalazion cannot resolve on its own without treatment.

Do children with chalazion need surgery? How is it performed?

Chalazia are also common in children and usually require surgery. If the child can cooperate, that is ideal. If not, the child may need to be restrained or undergo general anesthesia.

The surgery is simple and quick. For a single chalazion, the procedure typically takes about 5 minutes.

How to treat meibomian gland carcinoma?

The primary treatment is surgical, requiring complete removal of the lesion. If the condition is extensive, excision of related orbital tissues may be necessary.

How to treat a stye?

In the early stage, apply cold compresses. If the lump has not softened, switch to warm compresses twice a day for about 20 minutes each time. Use antibiotic eye drops and ointments in the conjunctival sac. For severe cases, oral or intramuscular antibiotics may be needed.

Some patients may recover with the above treatments.

If inflammation persists and a localized abscess forms, incision and drainage may be required.

DIET & LIFESTYLE

After developing a chalazion, what should be noted in terms of diet or lifestyle?

A light diet should be maintained, and greasy foods should be consumed sparingly.

Can a chalazion be popped by oneself?

This is not advisable, as it is generally difficult to pop on your own. Even if successfully popped, the contents may not be fully expelled, often leading to granuloma formation.

What should be noted after chalazion surgery? How should it be cared for?

Post-surgery, maintain eyelid hygiene, follow a light diet, and use prescribed eye drops as directed.

PREVENTION

How to prevent chalazion?

Maintain cleanliness of the eyelid margins, eat a light diet, and reduce consumption of greasy foods.