A chalazion is a chronic granulomatous inflammation of a meibomian gland or gland of Zeis in the upper or lower eyelid. (There are approximately 100 of these glands located near the eyelashes.) This common eye disorder is characterized by localized swelling within the tarsal plate, or it may break through the conjunctival or skin side. Mild irritation and blurred vision usually develop slowly over several weeks. (See Recognizing chalazion.) A chalazion may become large enough to press on the eyeball, causing astigmatism. A large chalazion seldom subsides spontaneously. It’s generally benign and chronic, and can occur at any age. In some patients, it’s apt to recur.
Obstruction of the meibomian (sebaceous) gland duct causes a chalazion.
A chalazion occurs as a painless, hard lump that usually points toward the conjunctival side of the eyelid. Eversion of the lid reveals a red or red-yellow elevated area on the conjunctival surface. Otherwise, it’s seen as an indurated bump under the skin of the upper eyelid.
Diagnosis requires visual examination and palpation of the eyelid, revealing a small bump or nodule. Persistently recurrent chalazions, especially in an adult, necessitate biopsy to rule out meibomian cancer.
Initial treatment consists of application of warm compresses for 10 to 15 minutes at least four times a day to open the lumen of the gland, soften the hardened oils blocking the duct, and promote drainage and healing. If such therapy fails, or if the chalazion presses on the eyeball or causes a severe cosmetic problem, steroid injection or incision and curettage under local anesthetic may be necessary. After such surgery, a pressure eye patch applied for 4 to 6 hours controls bleeding and swelling. After removal of the patch, treatment again consists of warm compresses. Antibiotic eyedrops are occasionally prescribed before and after cyst removal, but otherwise are of little value.
❑ Instruct the patient how to properly apply warm compresses: Tell him to take special care to avoid burning the skin, to always use a clean cloth, and to discard used compresses. Also tell him to start applying warm compresses at the first sign of lid irritation to increase the blood supply and keep the lumen open.
Review other book chapters online related to Chalazion:
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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More About This Book:
Title: Professional Guide to Diseases (Eighth Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2005 ISBN: 1-58255-370-X 
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