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Chalazion

A chalazion is a common condition in which a small lump or cyst develops in your eyelid due to a blocked oil gland. The condition can occur due to inflammation around the opening of the oil glands just behind your eyelashes. This is called blepharitis.

What is a chalazion?

A chalazion is a harmless cyst caused by a blocked meibomian gland in the eyelid. Meibomian glands in the eyelid produce an oil which helps keep the eye moist. If the gland becomes blocked, the oil builds up into a cyst which looks like a small lump in the eyelid. The lump can become irritated and red and, occasionally, infected.

A chalazion commonly occurs due to inflammation around the opening of the oil glands at the base of your eyelashes. This is called blepharitis.

Chalazions tend to only last a few weeks and are typically not painful.

Many chalazions can be treated effectively at home but if the infection spreads or if there is a large cyst that persists, the surgery may be possible to speed up the healing process.

Chalazion symptoms

Symptoms include:

  • A small lump which develops on an eyelid
  • Mild pain or irritation, particularly if it has just started - this usually settles
  • There is a chance of infection
  • Sight is not affected

Chalazions can occur in various sizes, with a small proportion potentially remaining as a painless lump on the eyelid for up to a few months. A chalazion may also spontaneously discharge when the lid is cleaned or when hot compresses are applied to the area.

Causes of chalazion

The inflammation is caused by a sensitivity to a common bacteria found on your skin. When the openings of the small oil glands around your lashes become blocked by inflammation, a small tender swelling will occur in the lid. This is known as a chalazion.

Other risk factors include rosacea - a common skin condition which can affect the eyelids and eye area. Although it is rare, chalazions can also be a result of an eye condition known as viral conjunctivitis.

Chalazion surgery

When is chalazion surgery required?

If the chalazion does not respond to the first stage of the treatment, it can be drained.

The procedure

Once you are lying comfortably on the operating table, the skin around the chalazion will be injected with local anaesthetic. This will sting at first but the lid will soon become numb. Although you will still be able to feel touch and pressure you should not feel any pain.

A small incision will be made on the inner surface of your eyelid so that the contents of the cyst can be drained. Ointment will be applied and a pad placed over your eye.

You will be able to go home on the same day.

Biopsy

If chalazions continue to occur, your surgeon may also conduct a biopsy by removing a small tissue sample from the chalazion lump. This will be examined for any indications of other serious medical conditions, such as cancer.

Aftercare

When the anaesthetic wears off, there may be some discomfort. To relieve this, you can take mild pain relief such as paracetamol. You should keep the pad over the eye for at least four hours as this reduces swelling and bruising. When you remove the pad, you will find some blood or discharge around your eye. Clean the eyelid with cooled boiled water and remember to use the antibiotic ointment as prescribed.

As this is a minor procedure which only involves surgery on the eyelid and not the eye, it should not affect your ability to work.

Benefits of surgery

The inflamed chalazion will be drained.

Risks of surgery

  • Your eyelid might be swollen and bruised for several days after your operation but this should settle after two weeks.
  • There is a risk of infection, but after the operation you will be given antibiotic ointment to apply, which should help prevent this.
  • A chalazion can come back after being removed. If this happens, please apply a warm compress to your closed eyelid. If it continues to persist then seek further medical advice.

Alternatives to surgery

A small proportion of the chalazions will form hard lumps on the eyelid, which, if present for a few weeks can be incised and drained under local anaesthetic. This chalazion removal procedure will leave no visible scarring.

As an alternative to chalazion cyst surgery, a doctor may administer a corticosteroid steroid injection into the hardened chalazion, which can potentially result in lightening of the skin surrounding the area.

Identifying a chalazion vs a stye

It can be difficult to differentiate between a stye and chalazion, as they are both lumps which develop around the eye and are similar in appearance. However, there are differences between styes and chalazions.

The main distinction is that styes tend to be painful and sore, whereas chalazions are typically painless. A stye can occur inside the eyelid or at the eyelash base and indicates an infection in the hair follicle or oil gland. In contrast, a chalazion is a sign of a blocked oil gland, although it can develop into a stye in some circumstances.

Chalazion in children

Most cysts disappear with time but can take weeks and sometimes many months, to go away. They are normally harmless and can be safely left to get better with time in most cases.

Symptoms, diagnosis and treatment of chalazion is similar in adults and in children.

When to seek further advice

Seek further medical advice if after treatment, your child experiences:

  • Increasing redness and soreness of the eye itself
  • Very blurred vision
  • Very noticeable and spreading redness together with a lot of swelling of the eyelid

Treatment

In many cases a chalazion can be treated at home.

For further advice on how to clean the eyelids of children and babies, please watch our instructional video here:

video transcript
To clean the eyelids the first step is to do a warm compress which softens the debris on the eyelids making it easy to clean off.
Place a clean face cloth under a hot tap, nice and hot but not hot enough to burn or be uncomfortable. Wring it out and hold the hot compress on top of the closed eyes for one or two minutes.
If the cloth becomes cool, warm under the tap again, wring and replace it on the closed lids.
Next we perform the cleaning for older children we use a moistened cotton pad. This can be moistened in warm tap water or by using a weak solution of baby shampoo or bicarbonate of soda.
Squeeze out any excess moisture.
First you clean the back edge of the eyelid. Pull down the lower lid and run the bud firmly but gently along the thin line of skin behind the lashes four or five times.
 Do the same for the top lid putting it up and away from the eye. Then we clean the lashes. For the top lid, close the eyes firmly and scrub vigorously at the base of the lashes doing a small part of the lid at a time and moving gradually along the width of the lid to do all the lashes.
In the same movement to use for brushing your teeth. Then open the eye, look up and repeat with the bottom lid lashes, again moving gradually along the lid to ensure all the lashes are clean.
Ideally older children should be taught to do this themselves.
For younger children we start again with a warm compress.  Then use a face cloth to clean the lid edges moistened in warm tap water or with a weak solution of baby shampoo or bicarbonate of soda.
After moistening wring out the cloth wrapped the cloth tightly around the index finger so it covers the length of the finger holding the rest of the cloth in the hand.
With the child's eyes gently closed lay the finger with the length of the cloth along the lashes apply gentle pressure towards the eye and wipe up in a sweeping motion two to three times to clean the upper lid.
The gentle pressure towards the eyes will allow the eyelids to turn out a little so that the back edge of the eyelids are cleaned. Then wipe down two or three times in the same way to clean the lower lid.
To clean the base of the lashes; with your child's eyes tightly closed use the length of the the finger covered by the cloth to rub quite vigorously along where the lashes come out at the skin moving along the eyelids so that all areas are cleaned.

Occasionally, the doctor will prescribe a short course of antibiotic ointment or drops to help any irritation and, if there is infection spreading from the cyst, antibiotics by mouth.

However, medication does not cause the cysts to disappear. If there is a large cyst which remains for a long time, it is possible to perform surgery to remove it.

In most cases, chalazion surgery in children is not medically necessary or recommended.

Chalazion treatment is available at Moorfields Private

You can self-fund or use private medical insurance to fund your treatment.

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