What is a Chalazion?

A chalazion, or meibomian cyst, is a harmless cyst that develops on the upper and/or lower eyelid.

As the most common type of eyelid lump, a chalazion is a cystic inflammation from one of the oil-producing glands found in the eyelid. Although benign and not a threat to the patient, chalazia may vary in size, and are generally uncomfortable and unsightly. They’re also quite common in children, usually as a result of blepharitis.

What Are The Causes of Chalazia?

The upper and lower eyelids contain multiple meibomian glands which secrete oils into the tear film to keep the eyes lubricated. When these glands become blocked due to certain conditions such as blepharitis, seborrheic dermatitis or rosacea, a chalazion may develop.

What Are The Complications That Come With A Chalazion?

Although unsightly, chalazia rarely lead to any visual problems. If the chalazion becomes infected, this could lead to a preseptal cellulitis which must be treated with oral antibiotics. Often the cysts form into into a hard eyelid lump, which may be present for many months. There are a few things you should not do with a chalazion in order not to make it worse.

What Are The Signs and Symptoms of a Chalazion?

A chalazion is typically characterised by a firm, red but painless swelling in the eyelid that develops over several weeks. Often, there may be more than one chalazion concentrated in the infected area, in both the upper and lower eyelids.

How Can You Prevent A Chalazion From Developing?

It’s possible to avoid getting a chalazion by practicing good lid hygiene. You should wash your hands thoroughly and often, especially before touching your eyes, eyelids, or the surrounding area. Wash your face daily and clean your eyelids with a cotton pad or a clean flannel with a drop of baby shampoo or a blepharitis cleaning solution. Medical treatment of skin conditions such as seborrheic dermatitis or acne rosacea can help to break the cycle of recurrent chalazia. There is limited evidence that certain supplements such as flax seed oil and omega 3 help to alter the oil composition of meibomian glands and prevent chalazia from recurring.

What Are The Treatments For Chalazia?

In most cases, a chalazion will resolve over time with the help of some home remedies, although this could take several weeks if not months. Treatment for chalazion include:

  • Warm Compress - You can start treating a chalazion during its initial phase with a warm compress, such as a clean washcloth soaked and wrung in hot water. Gently hold the warm compress over the chalazion for 10 to 15 minutes up to six times a day. This will help liquify the hardened oil, and stimulate the blocked oil gland to drain itself naturally. Remember to keep the washcloth for your own personal use, so as to avoid contaminating others. Heated eye masks which can be bought over the counter are also highly effective, as these tend to retain heat for longer periods of time.
  • Eye Massage – After your warm compress treatment, a gentle eye massage will further promote drainage of the meibomian glands. Make sure to wash your hands before applying pressure to the chalazion, and do not attempt to squeeze or pop it, as this will lead to tissue damage and further inflammation.
  • Go Makeup Free – It is important to forego any kind of eye makeup until your chalazion completely heals, and to ensure that makeup has been thoroughly removed before going to bed. Mascaras, eyeliners and heavy eyeshadows can clog the meibomian gland orifices and can be a culprit of chalazia over time. If you’ve experienced a chalazion, be sure to replace all eye makeup during this period, as it may have been contaminated by the bacteria.
  • Chalazion Surgery - This is a simple procedure which is performed under local anaesthetic to numb the eyelid. A small incision is made on the inside of the eyelid to allow the contents of the eye cyst to drain. This is effective in approximately 70% of patients. In certain patients, the cyst no longer contains liquid contents but is formed of inflammatory granulation tissue which do not respond well to surgery.
  • Steroid Injection - Steroids may be injected into the cyst to treat the inflammatory granulation tissue. Your ophthalmologist will advise the best eyelid cyst treatment for you.

One Stop Chalazion Service

We understand that a chalazion can be very frustrating to treat and unsightly and therefore you may opt to have it surgically removed. At The Ezra Clinic, we offer a one stop chalazion service where you can be reviewed and treated on the same day. This includes a consultation with one of our ophthalmologists, followed by surgery or steroid injection if required. This is performed as a day case procedure under local anaesthetic and takes about 30 minutes.

What is the recovery from a chalazion surgery?

Following surgery, you will be prescribed antibiotic ointment to use and a pad will be placed over the eye. We recommend keeping the pad on until the next morning. The antibiotic ointment is to be used four times per day for 5 days. At first, the eye may be bruised and swollen but this should subside over the following days. Although the majority of cysts should resolve, virtual follow up can be arranged if required.

Examples of Chalazia

Images left to right: cyst inside eyelid, chalazion upper eyelid, chalazion lower lid / lump on lower eyelid, cyst on eyelid