Chalazion
Published by Bupa's health information team, July 2008.
This factsheet is for people who have a chalazion, or who would like information about it.
A chalazion is a cyst (a small sac of fluid) on the inside of your eyelid. It's also called a meibomian cyst. Chalazions are one of the most common lumps found on the eyelid, and they mostly occur on your upper lid.
- About chalazion
- Symptoms of chalazion
- Complications of chalazion
- Causes of chalazion
- Diagnosis of chalazion
- Treatment for chalazion
- Related topics
- Questions and answers
- Video
- Sources
About chalazion
A chalazion is when one of the meibomian gland ducts in your eyelid becomes blocked.
The meibomian glands help to keep your eyes moist by preventing the watery layer on the surface of your eyes (tears) from evaporating. They do this by producing an oily film over the tears.
The eyelid is made up of several layers: skin on the outside, muscle, tarsal plates and the conjunctiva, which lines the inside of your eyelids and the outer surface of your eye. The meibomian glands are located within the tarsal plates and open onto the edge of your eyelid. There are around 50 tiny ducts in your upper eyelid and 25 in your lower eyelid.
Symptoms of chalazion
A chalazion usually starts as a lump on your eyelid. The lump will be hard and slightly inflamed. This quickly settles and a painless pea-sized lump is left. When your eyelid is lifted up and turned inside out (everted) you may see a smooth yellow cyst. The outside of your eyelid can look normal and the affected area isn't painful to touch.
However, if your chalazion grows excessively large, you may have some pain. Also, the cyst can sometimes become infected, causing your eyelid to swell and pus.
If you have any of these symptoms, you should see your GP.
Complications of chalazion
Occasionally, a chalazion can cause astigmatism. Astigmatism is when your cornea (the front part of the eye that covers the pupil) has an irregular shape. Instead of being its usual round shape, it's oval (a bit like a rugby ball). This makes focusing difficult and vision blurred.
A chalazion can put pressure on your cornea, forcing it to change the shape resulting in astigmatism.
Causes of chalazion
A chalazion is caused by a blockage in a meibomian gland duct in the eyelid. The duct may become blocked because of an infection, such as a meibomian stye (internal hordeolum) or an abnormal growth, such as a tumour (although this is rare). Usually blockages rupture by themselves, and the oily fluid trapped inside drains away naturally. However, if this doesn't happen, a chalazion forms.
Diagnosis of chalazion
Your GP or optometrist (a healthcare professional who examines eyes, tests sight and dispenses glasses and contact lenses) can diagnose a chalazion. He or she will ask about your symptoms and examine your eye.
Treatment for chalazion
A third of chalazions will resolve themselves and won't need any treatment. However, if your chalazion doesn't go away by itself, there are several treatments available.
Hot compress
A hot compress, followed by an eye massage, may help remove the blockage and release the fluids trapped inside the cyst.
Use a towel soaked in hot water to create a compress. The compress should feel comfortable on your skin - it shouldn't be scalding hot. Hold the compress against the affected area of your eyelid for five to 10 minutes. This will warm the fluids trapped inside the cyst.
Next, massage your eyelid by gently rolling your finger in a circular motion around the affected area. You should do this for about a minute. The massage will help to remove the blockage and release the trapped fluids.
Use a hot compress and massage four times a day, every day until the chalazion clears up.
Medicines
An eye ointment called chloramphenicol ointment may be used to treat your chalazion. You can buy this over-the-counter at your pharmacy. Always read the patient information leaflet that comes with your medicine, and if you have any questions, ask your pharmacist.
Alternatively, your GP may prescribe antibiotic ointment or tablets, especially if your chalazion is infected or if it keeps coming back. This may happen if you have another condition such as acne rosacea or seborrhoeic dermatitis.
If these medicines don't work, you may be referred to an ophthalmologist, a specialist who identifies and treats eye conditions (including surgical treatments).
Steroid injection
A steroid injection can be used to treat a chalazion. After giving you a local anaesthetic, your doctor will inject the steroid directly into the centre of the cyst, either through the skin of your eyelid or your eyelid will be everted and the cyst will be injected through your conjunctiva. If the cyst is injected through the conjunctiva you will be given a topical anaesthetic to completely block feeling from your eyelid. The cyst usually clears up within one to two weeks of treatment.
Surgery
If your chalazion is excessively large, uncomfortable or persistent, you may need to have it surgically removed using a procedure called incision and curettage.
Usually the procedure is done as an out-patient or day case at the hospital. A local anaesthetic is used to completely block feeling from your eye area and you will stay awake during the operation.
To remove your chalazion, your surgeon will evert your eyelid and apply a small clamp to the affected area. He or she will then make a small cut to the inside of your eyelid and remove the contents of the gland. This cut is left open to allow the gland to drain freely.
After the procedure, you will be given an antibiotic ointment to use four times a day for four days. Your eyelid may be swollen and discoloured for up to a week after the operation.
If you have a chalazion that keeps coming back despite treatment, it's important to see your GP as soon as possible. Occasionally, a chalazion can be caused by another underlying condition such as a skin disorder or, in very rare cases, similar looking lumps may be caused by a malignant tumour (cancer) in your meibomian gland, sebaceous gland or other parts of your eyelid.
Related topics
Video
See our video about chalazion:
Sources
- Khaw PT and Elkington AR. ABC of Eyes. London: BMJ Publishing Group, 2002
- Hordeolum and chalazion treatment: the full gamut. Optomety Today. www.optometry.co.uk, accessed 17 April 2008
- 18 Week patient pathway - gradual loss of vision (meibomian cyst): supplementary information. Department of Health July 2007 (version 1.3). www.dh.gov.uk
- Chalazion. GP Notebook. www.gpnotebook.co.uk, accessed 29 January 2008
- Blepharitis. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 10 April 2008
- Elton M. Ocular conditions from A to Z (ii). The Pharmaceutical Journal 2007. 278: 255-258.
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: July 2008.
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