A chalazion on the eyelid is a fairly common finding. Fortunately, these little bumps, while unattractive and annoying, are not cancerous and rarely require referral for oculoplastic surgery – there are other ways of how to get rid of a chalazion.
What is a Chalazion?
Chalazia (the plural of chalazion) are a result of a blockage of oils in a meibomian gland of the eyelid. These meibomian glands line the top and bottom eyelid margins and produce an oily sebaceous secretion as part of the tear film covering the surface of the eye. If one of these glands become clogged and obstructed, its secretions then accumulate within the duct, resulting in a chalazion of the eyelid. Chalazia are also known to occur following the resolution of a stye; this is then known as a secondary chalazion.
While a chalazion involves inflammation, by definition it is non-infectious. Chalazia are often confused with styes as both appear as bumps on the eyelid, however, a stye involves an infection, typically bacterial, while a chalazion does not. A chalazion usually appears as a firm, round, painless nodule on either the top or bottom eyelid though in the early days of development it may be slightly red and tender. Occasionally it may appear as though a section of the eyelid is generally swollen rather than being able to discern a discrete round bump. In some cases, a chalazion may be large enough to affect the movement of the eyelid, causing what is known as a mechanical ptosis. A very large chalazion also has the potential to cause some pressure on the cornea, which is the transparent front surface of the eye. As the cornea is responsible for bending and refracting light, a distortion to this tissue from the pressure of the chalazion can cause some temporary blurry vision.
A chalazion can happen to anyone though there are some factors associated with being more predisposed to experiencing recurrent chalazia. These include having chronic blepharitis, a common eyelid condition involving inflammation of the eyelash follicles and glands of the eyelid; acne rosacea, a skin condition affecting the face; and general poor eyelid hygiene.
A GP, optometrist, or ophthalmologist, including those specialising in oculoplastic surgery, can easily diagnose a chalazion. Diagnosis will typically involve examining the eyelid bump either with the naked eye, or more ideally, with a specialised microscope known as a slit lamp. A benefit of having the chalazion assessed by an eyecare practitioner with a slit lamp is that he or she can also view the eyelid structures in more detail, such as ensuring there are no unusual changes to the eyelashes near the bump, which may indicate a more sinister lesion mimicking a chalazion. The doctor will also want to gently touch the bump to assess its extent and determine whether touching it causes any irritation or tenderness. Once the bump has been properly identified and any other causes ruled out, your eyecare practitioner can then talk you through about how to get rid of a chalazion.
How to Get Rid of a Chalazion?
In most cases, it is not necessary to treat a chalazion as they are non-infectious and have the ability to self-resolve even if you choose to leave them alone. However, some people may be most concerned about the appearance of a chalazion, and as they can take weeks to months to clear on their own, may seek oculoplastic surgery. Before reaching this point, your eyecare practitioner may encourage you to first try using a warm compress as a simple home remedy. This involves soaking a cloth in warm water and placing it over the affected eyelid three to four times a day for five to ten minutes at a time. The heat may be sufficient enough to soften the clogged debris in the gland and allow it to be expressed through the duct.
At the same time, you may choose to apply some very gentle pressure on the bump to massage it in the direction of the eyelashes to encourage the gland to drain out. You should never try to pop or squeeze a chalazion as doing so could cause the blocked material in the obstructed gland to seep into the surrounding tissues, exacerbating further inflammation or inducing an infection. Antibiotic medications should also be avoided as they are ineffective when there is no active infection.
For people whose chalazia are causing significant concern, whether due to the cosmetic appearance, because the bump is taking too long to resolve, or if the chalazion is so large that it is causing a mechanical ptosis or distorted vision, treatment by an ophthalmologist experienced in oculoplastic surgery may be warranted. A chalazion can be treated using corticosteroid injections into the bump to clear away the inflammation and reduce the size of the bump. Risks of this treatment include changes to skin pigmentation at the injection site, particularly in patients with darker complexions. Alternatively, the ophthalmologist may recommend a surgical procedure known as an incision and curettage, which involves creating an incision with a scalpel under anaesthesia and physically removing the contents of the blocked gland. This treatment carries the risk of scarring or accidentally injuring the eyeball. Typically, the cortisone injection will be recommended before incision and curettage.
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