Chalazion Definition :
is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. Chalazia differ from styes (hordeola) in that they are subacute and usually painless nodules. They may become acutely inflamed but, unlike a stye, chalazia usually point inside the lid rather than on the lid margin
Single, nontender, firm nodule and more common in upper eye lid located deep in the lid or the tarsal plate (Hordeolum is superficial and centered on an eye lash)
1-Lid massage,moist heat,and topical mild steroid drops.
2-Chronic therapy with low-dose tetracycline.
Sumycin(tetracycline):250 mg qwk PO for 180 d (6 mo).
Pediatric Dose:<8 years: Not recommended
>8 years: 25 mg/kg/d (10 mg/lb) PO qwk.
This frequently prevents recurrence
3-If tetracycline cannot be used(pregnancy,lactation,contraception,hepatic and renal impairment,teething, then metronidazole has been used in a similar fashion.
Flagyl(metronidazole)500 mg qd for a few wk.<12 years: Not established
– Early cases of symptomatic chalazion:
1-vigorous massage between 2 cotton wool buds at the slit lamp under local anesthesia.
2-A wet facecloth, as hot as can be tolerated, can be applied twice daily.
3-4 fingers times 10 massage.
– infected chalazia :
1- heat and topical and/or systemic antibiotics.
2-In select cases, incision and drainage may be beneficial(Evacuate only the pus)
3-Topical steroids are necessary to prevent the chronic inflammatory response
4-Once the acute inflammation has subsided, revision and definitive curettage or excision of the granulomatous mass may be required.
In most cases, surgery should be performed only after a few weeks of medical therapy.
Atlas of Chalazion:
Chalazions are extremely common, and having a sound surgical technique to drain a chalazion is a fundamental in general ophthalmology and oculoplastic surgery. I believe one of the biggest downfalls in treating chalazions is inadequate local anesthetic. Please that both the outer and inner surface to the eyelid need to receive local anesthesia to make the patient totally comfortable. It is important to be careful in delivering the local anesthetic and making sure you have control of the head position, and the position of your needle is bent to minimize any possibility of contact with the globe.
Chalazion Educational Video
Chalazion Diagnosis and Treatment Notes