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Chalazion - Eyelid Swelling Often Confused with Stye

Preventing a Chalazion The word “chalazion” is derived from a Greek term which means a “small lump”. In general sense, a chalazion is an eye-related condition which causes swelling in the eyelid. It is mostly caused by inflammation of one of the small oil producing glands (meibomian glands) located in the upper and lower eyelids that lubricate the lid margins. The other medical / clinical names for chalazion are Meibomian Gland Lipogranuloma, Meibomian Cyst or simply a Tarsal Cyst.

What is a chalazion?
A chalazion is a swelling in the eyelid caused by inflammation of one of the small oil-producing glands located in the upper and lower eyelids.

What causes a chalazion?
A chalazion is caused due to blockage of a duct leading to the surface of the eyelid from the meibomian gland. The blockage may be due to infection (usually staphylococcal bacteria) around the duct opening.

Who is at risk?
People with oily skin or those who already have some pre-existing skin conditions such as acne or dermatitis are at increased risk of developing the chalazion.

How would you know if you have a chalazion?
A chalazion usually appears as a painless swelling on the eyelid. The eyelid may swell, and the eye may feel irritated. After a few days, these early symptoms disappear, leaving a painless, slow-growing, firm lump in the eyelid. Skin over the lump can be moved loosely.

Occasionally, other symptoms such as sensitivity to light, increased tearing, heaviness of the eyelid, sleepiness may also be present.

Sometimes a chalazion can cause the entire eyelid to swell suddenly, but usually there is a definite tender point.

When a chalazion is small and without symptoms, it may disappear on its own.

If the chalazion is large, it may cause blurred vision.

How is chalazion diagnosed?
Most often, you or your doctor can diagnose a chalazion by just looking at it. If you are already aware of the symptoms described above, it will be much easier for you to identify chalazion and differentiate it from a typical stye.

What is the difference between chalazion and a stye?
A chalazion is often confused with a stye, which also appears as a lump in the eyelid. However, both conditions are significantly different from each other.

A stye is an infection of a lash (eyelid hair) follicle that forms a red, sore lump near the edge of the eyelid. It is caused by bacteria and is often tender and painful. It does not involve an “oil gland”.

A chalazion, on the other hand is an inflammatory reaction (not an infection) of trapped oil secretions in the “oil glands”. It is not caused by bacteria, although the site can become infected by bacteria at later stage.

Unlike a stye, a chalazion tends to occur further from the edge of the eyelid and tends to “point” toward the inside of the eyelid.

Also, chalazion is usually painless apart from the tenderness caused when it swells up.

Speaking of its size, a chalazion tends to be larger than stye.

Medical treatment of a chalazion
Drug treatment of a chalazion includes steroid injections and topical (local) ointments / creams. Topical antibiotic ointments or creams, such as erythromycin, chloramphenicol or fusidic acid or bacitracin may be prescribed. You should apply a thin layer of medication to the lid edges 3 or 4 times daily. Similarly, antibiotic eye drops to prevent the spread of infection to other parts of the eye.

Oral antibiotics can also be used if recurrences occur.

Surgical treatment of a chalazion
Long lasting chalazia need to be surgically drained in the operation theatre of the eye hospital using local anesthesia. For example, if the chalazion is not markedly improved even after six weeks, your doctor can make a decision about surgery. Surgery is usually done from underneath the eyelid to avoid a scar on the skin.

Home-based treatment of a chalazion
At times, a chalazion can be treated at home with the help of the following tips:

  • Warm compresses (water soaks): These can be applied by holding a clean washcloth, soaked in hot water, against the closed lid. This can be done for five to ten minutes, three or four times a day. This may soften the hardened oils blocking the duct and promote drainage and healing and the majority of chalazia will disappear within a few weeks.
  • Massage: You should also lightly massage the area several times a day. However, do not "pop" or scratch the chalazion.

Are there any tips for prevention?
If you have a tendency to get chalazia, you should wash eyelid area daily with water and baby shampoo applied with a cotton swab. Also, using warm compresses and cleaning the eyelid margins can also decrease the chance of getting chalazion.

Are there any precautions you should be aware of?
If a chalazion recurs in the same place, your ophthalmologist may suggest a biopsy to rule out more serious problems. Also, be sure to notify your doctor / eye doctor if:

  • You or a family member has symptoms of a chalazion that last longer than 2 weeks
  • Eye pain occurs
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