Chalazion (Eyelid Cyst)

  • Medical Author:
    Andrew A. Dahl, MD, FACS

    Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Chalazion facts

  • A chalazion is a lump in the upper or lower eyelid caused by obstruction and inflammation of an oil gland of the eyelid.
  • A chalazion is not a tumor or growth and does not cause permanent changes in the vision.
  • A chalazion is very common and usually goes away without the necessity of surgery.

What is a chalazion?

A chalazion is a lump in the upper or lower eyelid caused by inflammation of a gland of the lid. It may be soft and fluid-filled or firmer. A chalazion is also referred to as a meibomian cyst, tarsal cyst, or conjunctival granuloma.

What are these eyelid glands?

Eyelid glands are called the meibomian glands. They are also known as the palpebral glands, tarsal glands, or tarsoconjunctival glands. There are 30-40 of these glands in each of the upper and lower lids. These glands produce a thick liquid secretion that is discharged into the tear film of the eye. This liquid is a mixture of oil and mucus and is called sebum. The liquid acts to maintain lubrication of the surface of the eye. The tiny openings of each of these oil or sebaceous glands are just behind the eyelashes at the lid margins of both the upper and lower eyelids.

What causes a chalazion?

The narrow opening through which a meibomian gland secretes its material can become clogged from narrowing of the opening or hardening of the sebaceous liquid near the opening. If this occurs, the gland will have a backup of the material it secretes and the obstructed gland will swell. This leads to thickening of the walls of the gland and leakage of oil into the lid itself, causing inflammation both within the gland and the eyelid. This inflamed enlargement is a chalazion.

Quick GuideCommon Eye Problems and Infections

Common Eye Problems and Infections

Sty vs. Chalazion

A sty is sometimes confused with a chalazion (see below), which is a cyst or a specific type of scarring due to chronic inflammation arising in the meibomian glands of the eyelid. A chalazion may develop when the infection of a sty persists over time, resulting in scarring around the meibomian gland. In contrast to a sty, a chalazion is usually painless.

What are risk factors for a chalazion?

Individuals with thicker Meibomian gland secretions than others have a greater risk of developing a chalazion. If you have had one chalazion, you are at greater risk of developing another one in the future. People with acne rosacea, because of alterations within the oil glands of the face, are at greater risk of developing chalazia. Seborrhea of the lids (dandruff of the lids) increases the risk of developing a chalazion.

What are the symptoms and signs of a chalazion?

The signs and symptoms of a chalazion are a non-painful lump under the skin in one of the four eyelids.

Is a chalazion like a pimple?

If the obstructed gland has bacteria within it, the gland may become infected. This is called a hordeolum, which does resemble a pimple, which really is an infected obstruction of an oil gland of the skin. A hordeolum may be tender to touch and resemble a pustule elsewhere in the body. A chalazion is not an infection but may follow or precede a hordeolum. A hordeolum is often referred to as a stye.

How do health care professionals diagnose a chalazion?

A chalazion is diagnosed by the medical history and the finding of a firm painless lump in one of the eyelids. This diagnosis can be made by inspection with a penlight with some source of magnification together with palpation (feeling) of the lump.

What types of specialists treat a chalazion?

Your family doctor can make the diagnosis and initiate treatment of a chalazion. If there is a question regarding the diagnosis or the chalazion requires surgical removal, your physician will refer you to an ophthalmologist, a medical doctor who specializes in the diagnosis and treatment of eye disease.

What are treatments and home remedies for a chalazion?

Most chalazions are treated with warm compresses to the eyelid to increase the circulation of blood to the inflamed area, encourage eyelid drainage, and promote healing. In addition, the doctor may prescribe an antibiotic drop or ointment to be used immediately after the compresses. If the chalazion persists and is causing an unsightly lump, it can be removed surgically as an outpatient procedure under local anesthesia. This excision is ordinarily performed through a small incision located on the inside of the affected lid using local anesthesia and a chalazion clamp. The removal of a chalazion neither alters the normal function of the lid nor decreases the amount of tears. The surgery removes only one gland of the 30 or 40 within the eyelid.

What is the prognosis of a chalazion?

In general, a chalazion does not affect sight. Rarely, the lump itself is large enough to distort the ocular surface and cause blurring of the vision. The vision will return to normal once the chalazion gets smaller or is removed. The pressure of the chalazion on the eye does not cause glaucoma. A chalazion is not malignant and has no potential to become malignant. A chalazion is not contagious.

Is it possible to prevent a chalazion?

Some individuals have thicker Meibomian gland secretions than others and, therefore, have a greater risk of developing a chalazion. If you have had one chalazion, you are at greater risk of developing another one in the future. People with acne rosacea, because of alterations within the oil glands of the face, are at greater risk of developing chalazia. The regular use of warm compresses applied to the closed eyelids for five minutes before bedtime can be helpful in preventing the Meibomian glands from clogging during the night. In people with seborrhea of the lids and recurrent chalazia, warm compresses and careful cleansing of the lid margins can be helpful for prevention. Some patients with recurrent chalazia can benefit by chronic use of oral low-dose tetracycline, which changes the metabolism of the oil-producing glands.

REFERENCES:

Dhaliwal, U. and A. "A rationale for therapeutic decision-making in chalazia." Orbit 24.4 (2005): 227-230.

Shields, C.L., S.E. Lally, and J.A. Shields. "Tumors of the eyelids." Duane's Ophthalmology, 2013 Edition. Ed. W. Tasman W and E.A. Jaeger. Philadelphia, PA: Lippincott Williams & Wilkins, 2013.

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Reviewed on 8/9/2017
References
REFERENCES:

Dhaliwal, U. and A. "A rationale for therapeutic decision-making in chalazia." Orbit 24.4 (2005): 227-230.

Shields, C.L., S.E. Lally, and J.A. Shields. "Tumors of the eyelids." Duane's Ophthalmology, 2013 Edition. Ed. W. Tasman W and E.A. Jaeger. Philadelphia, PA: Lippincott Williams & Wilkins, 2013.

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