• Chalazion Removal

  • What is a Chalazion?
    A chalazion is small or large bump in the eyelid caused by inflammation of one or more of the oil-producing, sebaceous glands (meibomian glands) located in the tarsal plates near the eyelashes in the upper and lower eyelids. The trapped oil secretions (sebum) may lead to inflammation and redness and sometimes discharge.

    What is a Stye?
    A stye is an acute infection of the sebaceous glands of the eyelid. They may occur internally or externally. Styes are much more uncomfortable than chalazia and are more responsive to topical antibiotic treatment.

    What are the Most Common Symptoms?
    Swelling of the eyelid may be localized or involve the entire upper eyelid. There is often tenderness to touch over the area of the involved oil gland. Patients with chalazia and styes frequently have signs and symptoms of blepharitis  including excessive matter and crusting on the eyelids upon awakening; a gritty feeling in the eyes; a burning sensation that is worse while reading, driving, watching T.V., or working at the computer. An oily and unstable tear film may result in dry, irritated, red eyes. Patients with rosacea have increased incidence of chalazia.

    How are Chalazia Treated?
    Medical treatment is similar to the management of blepharitis including eyelid hygiene, eyelid scrubs, and warm compresses. Topical antibiotics are usually of limited help with chalazia (unlike the infections that occur in styes).

    Warm Compresses
    The purpose of warm compresses is to open up the pores at the ends of the ducts where the glands drain onto the margins of the eyelids and ultimately into the eye. Warm compresses are warm or hot soaks placed over the closed eyelids.

    The best way to perform at least one of your hot compresses each day is to do so while in the shower. Turn the water temperature up a few degrees, place a face cloth across your eyes, turn your face toward the water stream, and allow your face and eyelids to soak in the warm water for five minutes or so (perhaps while you have conditioner soaking in your hair). Hot compresses should also be applied upon awakening and prior to going to bed. A dampened face cloth should be placed across the eyes for ten minutes. The face cloth may need to be reheated with hot tap water after four or five minutes. Some individuals like to heat a dampened face cloth in the microwave. This may help retain the heat within the cloth; however this must be done with extreme caution so as not to overheat the cloth and burn the skin. Be careful not to burn yourself with hot compresses. Remember, the compresses should be warm to hot, NOT scalding.

    Lid Margin Scrubs
    The purpose of eyelid margin scrubs is to clean the eyelashes and eyelid margin and to mechanically remove many of the micro-organisms that are growing on the edge of the eyelid.

    Dilute Baby Shampoo (Johnson’s No Tears or other similar brand) should be placed on a warm, damp wash cloth. The eyelashes and eyelid margin should be scrubbed with a back and forth motion with the eyes closed. Baby shampoo is used to limit eye irritation. This may be performed while in the shower or just prior to bedtime.

    Eyelid scrub pads are also available for purchase in most convenience and grocery stores.

    Surgical Treatment
    Chronic, cyst-like lesions that have not resolved with observation and warm compresses require surgical management. Posterior incision (on the inside of the eyelid), excision of the posterior cyst wall, and curettage of the involved area is performed as a minor office procedure with local anesthetic. Less frequently, an anterior incision is made through the skin if the lesion is “pointing” through the skin. Sutures and patches are not typically needed. A combined antibiotic-steroid eye drop or ointment is frequently prescribed for 7-10 days.

    Eyelid Margin Lesions
    Small lesions involving the eyelid margin (near the base of the eyelashes) are frequently the most difficult to manage. Aggressive surgical management may result in lid margin deformities. Local injections of corticosteroids may be helpful with difficult marginal lesions.

    Recurrent Chalazia
    Chalazia that recur despite surgical management should be biopsied to determine if an occult malignant lesion exists.

    Stephen R. Klapper, M.D., F.A.C.S. is a board certified Ophthalmologist and has completed extensive fellowship training in Ophthalmic Plastic and Reconstructive Surgery. In addition to his clinical practice Dr. Klapper has published numerous scientific articles in peer reviewed journals and presented several papers at regional, national, and international meetings on topics related to the field of eyelid and facial plastic surgery. Dr. Klapper’s practice is limited to adult and pediatric cosmetic and reconstructive eyelid and facial surgery, tear duct surgery, orbital disease, thyroid eye disease and the anophthalmic patient. Dr. Klapper also has extensive experience performing facial Botox® injections and Restylane® lip and facial fold injections. 

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