What Is Chalazion

Overview  

A chalazion is a painless swelling or bump that forms on the eyelid due to a blockage of the oil glands. This blockage prevents the normal flow of oil, leading to the accumulation and swelling of the gland. Chalazia typically start as a small, localized swelling on the eyelid, often near the eyelash line. Over time, the lump can grow in size, becoming more noticeable and potentially causing discomfort or irritation. While chalazia can affect both the upper and lower eyelids, they typically occur more frequently in the upper eyelid. While it seems to affect both males and females equally, specific figures regarding its prevalence are unavailable. Chalazia tend to occur more frequently during adulthood, typically between the ages of 30 and 50. 

It is typically caused by factors like bacterial infection or obstruction of the glands. Symptoms include a painless lump on the eyelid, redness, and tenderness. Diagnosis is usually made through a physical examination by an eye care professional. Treatment options include warm compresses, eyelid massages, and medications to reduce inflammation. In some cases, surgical drainage or removal may be necessary. Prevention involves maintaining good eyelid hygiene and avoiding eye rubbing. While chalazia are generally harmless, they can cause discomfort and affect vision in some cases. Immediate medical attention is needed if a chalazion becomes infected. Consulting an eye care professional is important for accurate diagnosis and appropriate treatment.^1,2

Causes of chalazion

A chalazion is primarily caused by the blockage or obstruction of the meibomian glands, which are responsible for producing the oil that lubricates the eyes. Several factors can contribute to this blockage. Here are some typical causes of chalazion:

1. Acne rosacea: A skin condition characterized by facial redness and acne-like symptoms
2. Meibomian Gland Dysfunction: This dysfunction can result from thickening of the glandular secretions, changes in the composition of the secretions, or inflammation of the gland openings
3. Seborrhea: A skin condition characterized by redness, dryness, flaking, and itchiness of the skin
4. Chronic Blepharitis: Blepharitis, which is the inflammation of the eyelid margins, can increase the risk of chalazion formation
5. Tuberculosis
6. Viral infection^1,4

It is crucial to emphasize that although these causes are frequently associated with chalazion, each individual case may involve unique factors that contribute to its development.

Signs and symptoms of chalazion

Stye Versus Chalazion: 

Distinguishing between a stye and a chalazion can pose challenges at times. Although both are eyelid conditions, they possess unique characteristics. A stye, known as hordeolum, manifests as a painful, red, and swollen bump near the eyelid edge, typically resulting from a bacterial infection. Styes are tender and may exhibit a yellowish spot. Fortunately, styes frequently resolve spontaneously or with the application of warm compresses.

The signs and symptoms of chalazion include:

1. Eyelid swelling: Chalazion typically presents as a localized swelling or bump in the upper eyelid or, less often, in the lower eyelid. The size of the swelling can differ among individuals. Occasionally, a completely swollen eyelid
2. Blurred vision: In some cases, a large chalazion can press against the eye, causing temporary blurred vision or distortion
3. Eyelid tenderness: Generally, chalazia are not painful, although there may be some tenderness when acute inflammation is present
4. Tear production: Chalazion occasionally affects tear production, which can result in excessive tears or, alternatively, dry eye symptoms
5. Mild irritation
6. Heavy eyes: A chalazion may cause an eyelid to feel heavy or weigh down^{1, 2, 5}

Management and treatment for chalazion

In most cases, chalazia tend to resolve on their own within a few weeks to a month without requiring treatment. However, it is common for chalazia to reoccur. The management and treatment of chalazion typically involve conservative measures and, in some cases, medical interventions. Here are some common approaches:

1. Warm compresses: Applying warm compresses to the affected eyelid for approximately 15 minutes, repeating this process at least 3  times a day over the course of several days can help soften the blockage and promote drainage. To create a warm compress, soak a clean, soft cloth in warm water and gently squeeze out any excess liquid. Remember to regularly moisten the cloth to ensure it remains warm and wet
2. Gentle massage: After applying a warm compress, gently massaging the eyelid in a circular motion may help facilitate the drainage of the blocked oil gland
3. Good eyelid hygiene: Maintaining proper eyelid hygiene involves carefully cleansing the edges of the eyelids using a gentle cleanser or baby shampoo, which can aid in preventing additional blockage and infection. It is advisable to refrain from wearing eye makeup during the presence of a chalazion. After the chalazion has drained, it is important to keep the area clean. Adhering to good practices for eye health and avoiding touching the eyes are also recommended
4. Steroid shots: If chalazia persist or are significant in size, a healthcare professional may administer a steroid injection directly into the chalazion to expedite the healing process and diminish swelling^1,6
5. Medications: Antibiotic medicines, ointment, and drops to alleviate inflammation and address any concurrent infection
6. Surgical intervention: In rare instances when conservative approaches prove ineffective, a minor surgical procedure known as incision and curettage may be conducted. This procedure involves making a small incision in the cyst and carefully removing its contents. It is performed under local anesthesia to numb the skin and the surrounding area. Antibiotic drops or ointment are often prescribed after surgery⁷

It's important to note that self-treatment measures may help in mild cases, but it is advisable to consult with a healthcare professional for proper diagnosis and guidance. 

Diagnosis of chalazion

A chalazion is typically diagnosed through a physical examination by a healthcare professional, such as an ophthalmologist or optometrist. The diagnosis involves the following steps:

1. Patient History: The doctor may ask about your symptoms and medical history to gather relevant information and rule out other possible causes of the eyelid swelling
2. External Eye Examination: The doctor visually inspects the affected eyelid and palpates the lump or bump to determine its size, location, and characteristics. They may also check for signs of inflammation or infection
3. Complete eyelid Examination: Using a light source, the doctor examines the front and back of the eyelid to look for signs of inflammation, infection, or other abnormalities. Additionally, the openings of the oil glands are examined⁶
4. Diagnostic procedures: The doctor may use a slit-lamp examination to evaluate the meibomian glands. This involves looking for thickened, yellowish contents coming from the openings of the eyelid margin. The doctor may also invert the eyelid to rule out other conditions like sebaceous carcinoma and check for the presence of a pyogenic granuloma
5. Laboratory tests: In cases of recurring or unusual chalazia, a pathologic evaluation may be requested. Microscopic examination of the materials extracted from a chalazion can reveal a lipogranulomatous reaction⁸

Risk factors of chalazion

Aside from the underlying causes, there are several additional risk factors associated with the development of chalazion. These risk factors include:

1. Previous history of chalazion
2. Poor eyelid hygiene
3. Eyelid surgery 
4. Eyelid injury
5. High levels of lipids in the blood
6. Demodicosis: infestation of demodex mites.
7. Gastrointestinal inflammation
8. Low levels of serum vitamin A
9. Smoking
10. Use of bortezomib: A first-generation proteasome inhibitor used in the treatment of certain types of blood cancers, known as hematological malignancies^8,9

It's important to note that while these risk factors can contribute to the development of chalazion, they do not guarantee its occurrence. If you have concerns about your risk or are experiencing symptoms of a chalazion, it's advisable to consult with a healthcare professional for an accurate evaluation and appropriate management.

Summary

Chalazia are painless swellings on the eyelid caused by blocked oil glands, predominantly seen between ages 30 and 50. These swellings typically appear as bumps on the upper eyelid, and their symptoms can include blurred vision, tenderness, and increased tear production. It's essential to differentiate them from styes, which are painful and result from bacterial infections.

Chalazia can arise due to various factors, including bacterial infection, acne rosacea, and meibomian gland dysfunction. Diagnosis usually involves a physical examination by an eye care professional, who will assess the patient's history and perform a thorough eyelid examination. While many chalazia resolve naturally, treatments might include warm compresses, massages, steroids, and, in rare cases, surgery. Emphasizing good eyelid hygiene is crucial for prevention.