Check-up chalazion

Last week I woke up with a very swollen, sore eyelid. A visit to the local emergency department resulted in a diagnosis of a chalazion. What is this?

A chalazion (chalazia – plural) is a small bump in the eyelid caused by a blockage of a tiny oil gland. The eyelid has about 100 tiny oil glands, called meibomian glands. They are located near the eyelashes and produce the fluid that lubricates the eye. A chalazion is caused by a blockage of the duct that drains one of these glands, resulting in a small bump in the eyelid.

My eyelid was so swollen I could hardly open my eye. Is this usual?

Initially, symptoms of a chalazion include eyelid tenderness, increased amount of tears and sensitivity to light. Typically there is painful swelling on the eyelid which can be quite extensive. With time, a chalazion becomes a small non-tender nodule or lump in the centre of the eyelid.

Although the condition can occur without obvious causes, recurrent chalazia may indicate an underlying problem such as blepharitis, a chronic eye condition, or a skin problem such as acne rosacea. These conditions can increase the risk of meibomian gland obstruction.

I was advised that this type of problem usually resolves without treatment. But what if it doesn’t go away?

Chalazia often resolve without treatment in a month or so. This occurs when the blockage drains through the inner surface of the eyelid and is absorbed spontaneously. However, the application of warm compresses to the eye lid for 10-15 minutes up to four times a day will help speed up the healing process. This softens the hardened oils blocking the duct, and promotes drainage. Chloramphenicol drops or ointment may be prescribed.

On rare occasions, a large chalazion can press on the cornea, causing vision problems including astigmatism – a distortion of the lens that causes blurring of vision.

If a chalazion does not resolve, increases in size or causes vision problems, it can be surgically removed under local anaesthetic. The incision is made underneath the eyelid to avoid scarring. Antibiotic eye drops are usually prescribed for use before and after the chalazion is removed. Astigmatism resolves when the chalazion is removed.

An alternate treatment option is for steroid to be injected directly into the chalazion. Whatever option is chosen, contact lenses and eye make-up should not be used until the chalazion is completely healed.