Most people have heard of styes mainly because they have had one. A chalazion is somewhat similar to a sty, but it is not the same thing. A sty is an acute infection of one of the oil-producing glands of the upper and lower eyelids, called meibomian glands. Each eye has 30-40 meibomian glands.
A chalazion is a clogged meibomian gland. The gland becomes blocked and oil builds up inside it. Eventually, the gland breaks open and leaks excess oil into the surrounding tissue, causing inflammation. While chalazia can hurt like styes do, they are more frequently painless lumps on the upper or lower eyelid. They occur most frequently in persons 30-50 years of age, but children can also get them.
Chalazia are often confused with styes because they are often initially red, tender and swollen before changing into a painless, slow-growing lump. They start out very small but can grow to the size of pea.
As they enlarge they can begin to press on the eyeball and can cause visual disturbances and corneal distortion.
Chalazia are usually deeper inside the eyelid than styes but sometimes occur as an after-effect of a sty.
Signs or symptoms of a chalazion
- Appearance of a painless bump or lump that may grow to 1/8 of an inch on the upper or lower eyelid
- Excessive tearing
- Blurred vision, if the chalazion has gotten to a size where it presses on the eyeball
Most chalazia disappear without treatment in several weeks to a month. However, they often recur. Rarely, they may be an indication of an infection or skin cancer. Certain conditions make one prone to developing a chalazion. They include:
- Chronic blepharitis, an inflammation of the eyelids and eyelashes (often due to a chronic dry eye condition)
- Acne rosacea
- Viral infection
A chalazion can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the eyelids, may include:
- Medical history to determine any symptoms the patient is experiencing and the presence of other health conditions that may be contributing to the eye problem and help identify the correct diagnosis.
- Vision testing and external examination of the eye including special inspection of the eyelids.
- Evaluation of oil gland openings using bright light and magnification.
An ophthalmologist can identify whether or not you have a chalazion and advise you of treatment.
Often, chalazia resolve on their own within a few weeks without medical intervention.
Warm compresses applied to the eyelid help facilitate healing. They should be applied 10 to 15 minutes at a time 4 to 6 times per day for at least a week. The heat from the compress can help soften the hardened oil that is blocking the duct, allowing it to drain. Massage can also help it to drain. Massage should be performed lightly and gently for about five minutes every day. Moist compresses can also help. A clean cloth can be dipped in hot water and applied to the closed eye. When an irritation is present, it is very tempting to touch the eye which should be avoided. If you do touch your eyelid area, make sure your hands are very clean.
If the chalazion does not drain and heal within a month, contact your ophthalmologist. Do not attempt to “pop” the chalazion as you can increase the blockage and the inflammation this way, and possibly cause an infection. If a chalazion does not heal on its own, more aggressive treatments may be tried.
If a bacterial infection is suspected, a prescription for antibiotic eyedrops or ointments may be given. Steroid injections in the area surrounding the chalazion may help decrease inflammation.
If a chalazion creates significant symptoms or lasts for weeks, it may need to be surgically removed. If the swelling has lasted more than a few weeks or creates symptoms of mild blurring of the vision, your ophthalmologist may recommend surgery to remove the chalazion. If the appearance of the chalazion bothers you, surgical removal may also be indicated.
If you have multiple chalazia or recurrent chalazia, there may be a consistent abnormality in the oil glands. One condition that can give rise to such an abnormality is acne rosacea. In such instances, it can be treated with long-term oral tetracycline to alter the consistency of the oils produced by the glands, making it more liquid. The use of warm compresses prior to sleep and cleaning the lid margins with baby shampoo can also decrease the chance of getting chalazia if they are a chronic problem.
If surgery is required, it is usually a simple outpatient procedure that takes only fifteen minutes to perform. In most cases, the doctor will make an incision on the underside of the eyelid to prevent visible scars. However, if the chalazion is quite large, it may be necessary to make the incision on the surface of the eyelid. Usually, eyelid skin heals well and scars are not noticeable. The greatest risk is excessive bleeding, so blood-thinning medications such as aspirin should not be taken prior to surgery. Typically, there are no complications and healing is rapid. Your ophthalmologist will normally conduct a follow-up exam to make sure your eye has healed properly. In some cases, chalazia, once removed, may be biopsied, as they are rarely linked to cancer.
Alternative treatments for chalazia include castor oil compresses, acacia leaves and guava leaves. All three contain strong anti-inflammatory substances that can decrease inflammation and, therefore, swelling, which increases the chance of the chalazion draining on its own. Castor oil can be applied by soaking a piece of flannel in the oil and then placing it gently on the eye. To use acacia leaves, boil them first, let cool and then apply them to the eyelids. For guava leaves, lay a leaf on your eyelid with a warm compress over it.
If you suspect you have an eye problem, visit your ophthalmologist as soon as possible. Many eye conditions respond better to prompt treatment, and chalazia are no exception.