A chalazion is a painless inflammation characterised by a lump or nodule formed on the upper or lower eyelid. A chalazion is non-infectious and usually does not affect vision, however when large and especially when occurring in the upper lid, the lump can put pressure on the eye and cause irregular focus called astigmatism. Chalazia are commonly seen in adults 30 to 50 years of age, and also in children.
A chalazion may look similar to a stye, which is a painful red lump that occurs as a result of infection of the eyelid glands. Chalazion manifests as a painless, red, tender bump on the eyelid. It starts out very small but can soon grow into a bump the size of a pea, occasionally the overlying skin can become very red and at times even ulcerate. Chalazion may cause blurred vision (see above). Unusually they become infected (then develop pain) and very rarely a cancer may appear initially as a chalazion.
A chalazion is due to a blocked gland (the meibomian gland). These glands are present on the eyelids within the “eyeward” side of the substance of the eyelid. Blockage of these glands may result in the accumulation of oil in the gland leading to inflammation of the gland and surrounding tissue.
Certain factors increase the risk of developing a chalazion. These may include
- Chronic blepharitis (inflammation of the eyelids or eye lashes)
- Acne rosacea (redness also of blood vessels on the face)
- Seborrhoea (overactive sebaceous glands causing oily skin)
- Meibomian gland dysfunction (e.g. poor oral Omega-3 intake)
The diagnosis of a chalazion is based on medical history and the physical examination of the eyes as well as eyelid margins.
Most chalazia may subside without the need for any treatment in a few weeks to a month, but they often reoccur. Treatment is the same as for a stye, which includes regular application of warm compressions on your eyelids at the early onset of the chalazion. Children will be advised to maintain eye hygiene by regularly washing their hands and rinsing their eyelids with warm water. Children are instructed not to rub or squeeze the affected area of the eye. Both adults and children can benefit from regular lid cleansing with diluted baby shampoo. All are encouraged to have oral dietary or supplementary intake of Omega-3 and avoid excessive pro-inflammatory Omega-6 such as in many processed packaged snacks. When symptoms do not improve, surgical removal of the chalazion may be recommended. In children, general anaesthesia is required and hence done in operating theatres. Most of these will spontaneously resolve nearly fully by 18 months, most of the regression in first 9 months. In adults, only local anaesthesia is needed, and the removal is done in the office setting.