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Picture of a chalazion. Photo courtesy of Andrew A. Dahl, MD, FACS.

• 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.

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. Meibomian cyst, tarsal cyst, lipogranuloma, or conjunctival granuloma are other names for a chalazion.

Meibomian glands are eyelid glands. Palpebral glands, tarsal glands, or tarsoconjunctival glands are other names for the eyelid glands. There are 30-40 of these glands in each of the upper and lower lids. These glands produce a thick liquid secretion that discharges into the tear film of the eye. This liquid (called sebum) is a mixture of oil and mucus. 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 (edges) of both the upper and lower eyelids.

Narrowing of the opening or hardening of the sebaceous liquid near the opening can clog the narrow opening through which a meibomian gland secretes its material. 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 within both the gland and the eyelid. This inflamed enlargement is 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, who have abnormalities within the oil glands of the face, often also have Meibomian gland dysfunction, placing them at greater risk for developing chalazia. Seborrhea of the lids (dandruff of the lids or seborrheic dermatitis) also increases the risk of developing a chalazion.

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

If the obstructed gland has bacteria within it, the gland may become infected. This is 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. Hordeolum is another name for a stye.

A doctor uses a patient's medical history and the finding of a firm painless lump in one of the eyelids to diagnose a chalazion. This diagnosis can be made by inspection with a penlight and some source of magnification together with palpation (feeling) of the lump. The diagnosis of a chalazion includes investigating other causes of lid lumps, including benign and malignant growths, such as basal cell carcinoma. Your physician will suggest a biopsy if he or she suspects that the lump might be a tumor.

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 (eye doctor), a medical doctor who specializes in the diagnosis and treatment of eye disease.

People can treat most chalazions 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 use immediately after the compresses. If the chalazion persists and causes an unsightly lump, it can be removed surgically as an outpatient procedure under local anesthesia. Ordinarily, a medical professional performs this excision by making a small incision located on the inside of the affected lid using a local anesthesia and a chalazion clamp. A physician will remove the contents of the chalazion and surgically remove the wall of the chalazion. 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. An alternative to surgery involves administering a steroid injection into the affected gland (known as an intralesional injection) to reduce the inflammation.

In general, a chalazion does not affect sight. Rarely, the lump itself is large enough to distort the ocular surface, including the cornea, and cause some temporary astigmatism with blurring of the vision. The vision will return to normal once a medical professional removes the chalazion or it gets smaller. 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. A chalazion differs from an external hordeolum (stye) in that a chalazion contains no infected material. Rarely, multiple chalazia of the same eyelid can lead to physical changes in the lid, causing eyelashes to turn in toward the eye (trichiasis).

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.