A chalazion is a pea-sized benign eyelid cyst that forms in response to chronic inflammation within an eyelid oil gland. It may occur cor no apparent reason at any age within the upper or lower eyelid. Frequent chalazia are seen in patients with chronic blepharitis, a low grade infection of the eyelid margin, glands, and lashes.
Acute chalazion presents suddenly with itching, swelling, pain, and redness and is often confused with a sty (a true meibomian gland infection).
Chronic chalazion appears more gradually as an enlarging lump with little associated discomfort or eyelid redness. The skin appears normal over the internal mass while a smooth white bump may sometimes become visible on the inner surface of the eyelid.
Warm compresses are often recommended although they probably accomplish little other than to provide comfort and kill time as the swollen eyelid heals itself.
Because chalazion is not an infection, it does not respond to oral antibiotics or medicated eye drops or ointments. Most acute chalazion cysts shrink fully without special treatment over several weeks. In some cases, the inflammatory process quiets down but leaves behind an internal core that can be felt as a tiny lump the size of a BB or seed.
Sooner of later, any retained core leaks and the inflammation reappears. Repeated attacks of eyelid puffiness and deep inflammation from a chronic chalazion can gradually deform the lid or distort the eyelashes.
A granuloma, a reactive fleshy growth protruding from the back of the eyelid, may sometimes develop, enlarge, and cause additional irritation and discharge (see photo).
Chalazion removal is a minor office surgical procedure that takes about ten minutes and requires the injection of local anesthesia. Following excision, the eye is covered by a patch for several hours. Eyelid swelling disappears over several days. In cases with extreme inflammation, there may be multiple chalazia present that can easily be overlooked and necessitate a second procedure after the lid recovers from the first operation.
Chalazion cysts may also be treated by a series of steroid injections rather than surgical removal. While used in young children or the uncooperative elderly to try to decrease inflammation, this method of treatment is a poor second choice to full removal.
Painless eyelid growths without inflammation can be caused by other eyelid disorders. An eyelid mass that requires repeated surgical procedures for recurrence may instead be a slow-growing eyelid cancer. The diagnosis of malignancy is made by submitting a specimen from the biopsied growth to a laboratory for microscopic analysis.
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