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Chalazion: causes, symptoms, diagnosis, treatment

 
, medical expert
Last reviewed: 05.07.2025
 
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A chalazion is a noninfectious occlusion of a meibomian gland causing migration of irritating fatty material into the soft tissues of the eyelid and a focal inflammatory reaction. A chalazion has a sudden onset of local swelling of the eyelid; a chalazion is caused by noninfectious occlusion of a meibomian gland. A chalazion initially causes hyperemia and swelling, tenderness of the eyelids; over time it becomes a small painless nodule. Diagnosis is clinical. Treatment is with hot compresses. A chalazion improves spontaneously, but incision or intralesional glucocorticoids may be used to speed resolution.

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What causes chalazion?

Occasionally, chalazion occurs as a result of barley, although it often occurs independently. A predisposing factor for the development of chalazion is considered to be blockage of the meibolic gland duct and reactive inflammation around the drops of sebum, which breaks through into the surrounding cartilaginous tissue.

Symptoms of Chalazion

Chalazion causes redness of the eyelid and swelling, puffiness and pain. After 1-2 days, a small painless nodule or bulge appears, directed towards the inner surface of the eyelid or occasionally towards the outer surface. Chalazion usually opens spontaneously or resolves within 2-8 weeks, but may persist longer.

Under the skin of the eyelid, in the absence of inflammatory processes, a small, dense, non-painful formation appears first. This formation, slowly increasing, becomes visible from the skin. The skin above the formation is not changed, and from the conjunctiva it shines through in gray. As it increases in volume, the chalazion can press on the cornea from time to time, causing the development of astigmatism, and probably distortion of vision. Small chalazions have every chance of spontaneously resolving. Sometimes the chalazion opens on its own to the surface of the mucous conjunctiva. In such a situation, granulation develops around the test hole. Chalazion usually does not cause painful sensations, although it is a cosmetic defect. The simultaneous occurrence of several chalazions on the upper and lower eyelids is quite possible. Chalazion consists of granulation tissue and a large number of epithelioid and even giant cells, resembling the structure of tubercles, although it has nothing in common with the tuberculous process. Chalazion differs from barley in its greater density. The skin above the chalazion is easily moved, its color is not changed. In case of recurrent fast-growing chalazions, differential diagnostics with adenocarcinoma of the meiboli gland is required. To resolve the issue, a histological examination of a piece of this tissue is required.

Slow (over several months) growth of the formation, its fusion with the tarsal plate, and intact skin provide grounds for easily establishing the diagnosis of chalazion.

The diagnosis of chalazion is clinical. If the chalazion is located near the internal commissure of the eyelids, it must be differentiated from dacryocystitis, the diagnosis of which can usually be excluded by detecting maximum compaction and pain in the eyelid area for chalazion and the nose for dacryocystitis. In case of successful lacrimal duct irrigation, dacryocystitis can be excluded. Chronic chalazion that does not respond to treatment requires biopsy to exclude an eyelid tumor.

What do need to examine?

How to examine?

Chalazion treatment

Most chalazia resolve gradually over 1 to 2 months. Hot compresses for 5 to 10 minutes 2 or 3 times daily may be used to speed resolution. Incision and curettage or glucocorticoid injection (0.05 to 0.2 ml triamcinolone 25 mg/ml) may be indicated if the chalazion is large and persists for more than a few weeks despite conservative therapy.

Treatment for an internal stye involves oral antibiotics and incision and drainage if needed. Topical antibiotics are usually ineffective.

At the initial stage, local injections of kekalog into the chalazion area at a dose of 0.4 ml are used. Sometimes, with small chalazions, resorption is facilitated by massage with 1% yellow mercury ointment, instillation of glucocorticoids. Eye ointment with antibiotics behind the eyelids. Introduction of 0.3 ml of triamcinolone acetonide into the thickness of the chalazion. It is also recommended to use dry heat - blue light, UHF.

Chalazion removal

If there is no improvement, surgical treatment is indicated - removal of the chalazion from the conjunctiva or eyelid skin, depending on the localization of the pathological process. Surgical removal of the granuloma is performed under anesthesia with a 0.25% solution of dicaine or a 1% solution of novocaine. To remove the chalazion, the eyelid is clamped with special terminal tweezers. A small incision is made in the conjunctiva in the area of the chalazion perpendicular to the edge of the eyelid. The contents are scraped out through the incision with a sharp spoon, separated with scissors and the capsule is removed. The resulting cavity is cauterized with a solution of iodine tincture. Ointment is placed behind the eyelids, then a slightly pressing bandage is applied for one day. Healing occurs within 2-3 days.

What is the prognosis for chalazion?

Chalazion has a good prognosis. Formation of new chalazions is possible.

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