Chalazion (meibomian cyst)

A chalazion is a firm round lump in the upper or lower eyelid caused by a chronic inflammation/blockage of the meibomian gland. It can sometimes be mistaken for a stye. Unless acutely infected, it is harmless and nearly all resolve if given enough time.

Symptoms

  • Eyelid swelling or lump
  • Eyelid tenderness
  • If inflamed, eye can be red, watering and sore
  • Heaviness of the eyelid 

Signs

  • Tender or non-tender round swelling, can be red, on or within the eyelid +/- mild conjunctivitis 

Eye examination

  • Examine lids and conjunctiva with a white light
  • Watch out for spreading lid cellulitis
  • The presence of a chalazion is confirmed 

Treatment

  • Give patient chalazion information leaflet
  • Show patient how to apply a warm compress which can be used to increase drainage of the affected gland
  • Show the patient how to gently massage after warm compress to help to express the contents of the cyst
  • If acutely inflamed, prescribe chloramphenicol ointment tds 1-2 weeks
  • Chalazia will often disappear without further treatment within a few months and virtually all will re-absorb within two years
  • If conservative therapy fails, chalazia can be treated by surgical incision into the tarsal gland followed by curettage of the retained secretions and inflammatory material under local anaesthetic