A chalazion is a blocked up, inflamed meibomian gland. It is an inflammatory lesion and not an infection. It is not a stye. The meibomian glands are located in the eyelids. They produce an oily secretion which slows the evaporation of the tear film from the surface of the eye.
They have tiny pin-point openings along the length of the eyelids, just behind the line of the eyelashes. Sometimes a meibomian gland duct becomes blocked by dried secretions. It begins to swell and may become infected. The swelling then subsides, often leaving a firm lump.
A typical upper eyelid chalazion (meibomian cyst) and a small central lower eyelid chalazion
A chalazion being curretted with the removal of typical gelatinous contents. This patient also has a granuloma (a small pink fleshy lump) at the inner aspect of the everted upper eyelid which may be seen as a reaction to a chalazion which has burst erupted on the inside of the eyelid).
A chalazion or meibomian cyst is treated with antibiotic ointment to prevent a secondary infection, the application of heat treatment and gentle massage towards the eye after applying the antibiotic. If the chalazion persists, it can be removed by means of a procedure referred to as an incision and curettage (I+C). This is done under local anaesthesia in adults and under a very short general anaesthetic in children. A local anaesthetic injection is given just under the skin of the eyelid. A special clamp is placed around the cyst to protect the eye and to prevent bleeding. The clamp is used to evert the eyelid so that the incision is made on the inside of the eyelid, avoiding a visible scar. The contents of the cyst are curetted out and the clamp removed.
An incision has been made into the upper lid tarsus with the contents of the chalazion exposed
The appearance following a thorough curettage of the chalazion
Antibiotic ointment is instilled into the eye and an eye patch is placed. Click here if you would like to see how this very short procedure is undertaken at the Face & Eye clinic.
You will be instructed to remove the patch the following day after thoroughly washing your hands. You should clean the eye with cotton wool and sterile saline or with cool boiled water. You should then use antibiotic ointment to the eye 3 times a day for 5 days. A chalazion may recur in a small proportion of patients. If blepharitis is the underlying cause, it is important to keep this under good control. For a very small proportion of patients a postoperative steroid injection may be used to help a chalazion to resolve. This is usually required for patients who have had a chalazion for a period of a few months with chronic inflammation.