Definition

A chalazion is a lump on the eyelid caused by a blocked oil gland in the eye. The eyes contain many oil glands that help form the outermost layer of tears. When one or more of these glands becomes blocked, a chalazion can develop. This lump usually starts as a red bump that gradually matches the skin color. The lump may remain on the eyelid for weeks or may come and go.

Chalazion is the most common cause of eyelid lumps worldwide. Chalazion is an inflammatory lesion found in approximately 13.4% of benign eyelid lesions. Chalazions are more common on the upper eyelid due to the abundance of oil glands (meibomian glands) on the lower eyelid. Chalazion can affect individuals of all ages and occurs equally in both men and women.

Causes

To protect the eyeball, tears need to be resistant to quick evaporation. This function is supported by an oil layer produced by glands in the upper and lower eyelids. When the oil is too thick, the Meibomian glands may become blocked, leading to inflammation and the formation of a chalazion on the eyelid.

Risk Factor

Certain groups are at higher risk of developing chalazion, including:

• Adults, compared to children
• Those frequently experiencing eyelid inflammation, such as blepharitis
• People with specific skin conditions, like seborrheic dermatitis or acne rosacea
• Individuals with diabetes
• Those who have previously had a chalazion
• Individuals with Demodex mite infections on the eyelids
• People with low serum vitamin A levels
• Individuals with gastrointestinal inflammation
• Those using the chemotherapy drug Bortezomib

Symptoms

Initially, a chalazion appears as a red, swollen lump on the eyelid, painful to the touch. After a few days, the pain subsides, but the lump remains. Additional symptoms you may experience include:

• Watery eyes
• Redness in the eye
• Blurred vision

A condition similar to chalazion is a stye (hordeolum), caused by an infection, and typically more painful, swollen, and red. With a stye, you may see a yellow spot at the tip of the lump, which does not appear in chalazion. Once the inflammation phase has passed, chalazion lumps are typically skin-colored and not red.

Diagnosis

There are no specific examinations for chalazion. Your doctor may ask about your eye symptoms and general health. If you've had a chalazion before, your doctor may recommend seeing an ophtalmologist to identify other eye conditions. A slit-lamp examination may be performed to assess the Meibomian glands and identify blockages. For recurrent chalazions, an ophtalmologist may take a tissue sample from the lump to rule out other conditions such as sebaceous carcinoma, pyogenic granuloma, sebaceous hyperplasia, keratosis, and cysts that resemble chalazion.

Management

A chalazion may resolve on its own over a few days or weeks without any treatment. Small chalazions often require no treatment.

Medical Therapy

Your doctor may recommend eye drops or ointments to aid in chalazion healing. If these are ineffective, steroid injections may be prescribed to reduce the chalazion. Steroid injections require careful monitoring of eye pressure. For more severe cases, the lump may be drained surgically. Local anesthesia is used before the surgery. Since chalazion is not an infection, antibiotics are generally not needed unless a bacterial infection, such as blepharitis, is suspected. If you have a Demodex infestation, your doctor will treat that as well.

Home Remedies

• Apply a warm compress to the eyelid with a clean cloth for 10–15 minutes.
• If the lump is still inflamed, apply a warm compress and gently massage the chalazion to help open the gland duct.
• Cleanse the eyelid with baby shampoo or eyelid cleanser, available over the counter.
• Avoid pressing or trying to pop the chalazion, as this can lead to infection and worsen the condition.

With proper home care, a chalazion may shrink or disappear within a few weeks. Untreated, a chalazion can persist for four to six weeks.

Complications

A large chalazion can cause astigmatism and blurred vision. Due to infection, you may experience pain that requires surgery or curettage.

Complications from steroid injections include infection at the injection site, tissue necrosis, atrophy, increased eye pressure, and lightening or darkening of the skin around the injection area.

Prevention

If you've experienced a chalazion, you're likely going to experience it repeatedly. Therefore, keeping eyelid hygiene is essential.

• Wash your hands before touching your eyes or handling contact lenses.
• Cleanse your face and eyes before bed to remove makeup and dirt after outdoor activities, as pollution, dust, and makeup can clog the Meibomian glands.
• Replace eye makeup, such as mascara, every 2–3 months, and discard expired makeup.
• Avoid sharing makeup tools with others.
• If you're prone to eyelid infections (blepharitis), regularly clean your eyelids with baby shampoo.

When to See a Doctor?

If you experience recurrent chalazions in the same location, if they don’t resolve with treatment, or if they have an unusual appearance, you should consult an ophtalmologist for further evaluation.

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