Chalazion

Chalazion is a painless nodule of the eyelid near the eyelashes. It is caused by inflammation of specialized oil glands of the eyelid that reside behind the eyelashes. This inflammation is thought to be due to thick oil clogging up the oil glands. Chalazion is commonly associated with blepharitis, meibomian gland dysfunction and acne rosacea, but it can also occur without these associated conditions.

The treatment for chalazion is conservative initially with warm compresses four times daily for 15 minutes each time. In more severe cases, antibiotic ointment with steroid may be prescribed to help with the acute inflammation. If chalazion is refractory to conservative management, it can be incised and drained under local anesthesia in the office. This involves making 3-mm incision on the back side of the eyelid and removing inflammatory material from the oil gland. There is no suture, little discomfort and no down time involved. The eye is typically not patched, unless a pressure patch is needed for bloody discharge, which is normal. The patch may be removed the next morning, and all normal activities are resumed.

If there is residual inflammation or scaring of the oil gland after the incision and drainage, injections of Kenalog and 5-FU may be placed in the eyelid to help bring them down further.

For patients with tendency to develop chalazia, it is strongly recommended that they continue daily preventative regimen. This consists of warm compress with massage over the oil glands and Omega-3 and Omega-6. These measures can help thin the oil and open and drain the oil glands. If patients have blepharitis, daily lid scrub with tea tree oil or hypochlorous acid should be performed after the warm compress. Some patient may require long-term use of antibiotic gel or pill that has anti-inflammatory property to suppress the inflammation and thin the oil in oil glands.