Chalazion: what it is, how long it lasts, remedies and when to operate
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A chalazion is a firm bump on the eyelid, usually painless or only mildly tender, that forms from a stye (hordeolum), which appears when a meibomian gland becomes blocked and inflamed. It can appear on the upper or lower eyelid, grow over several weeks and, if large, press on the eye and cause blurred vision. When a stye persists for about 4 weeks, it becomes a chalazion.[1]
The cause is a blockage in the duct of a meibomian gland or of the sweat glands around the eyelid. The contents thicken and build up, and the body reacts with significant inflammation. It is more common in people with blepharitis, meibomian gland dysfunction, rosacea, seborrheic dermatitis or oily skin, and in those who have had chalazia before.[2]
A stye is an acute infection: the eyelid becomes red, warm, swollen and painful, with a spot of pus at the edge. A chalazion is a firm, slow-growing nodule with almost no pain, which can remain when a stye does not resolve. One can give rise to the other.[1]
Many small styes go away on their own in about a month with proper care, although some take longer. If after several weeks the bump is unchanged, the inflammation continues or it keeps growing, you should see an ophthalmologist.[1]
What helps: warm (not hot) water compresses over the closed eyelid for 10 to 15 minutes, at least four times a day, followed by a gentle massage and cleaning of the eyelid margins. The heat softens the oil and helps it drain.
What not to do: squeeze, pop or prick the bump, wear makeup over an inflamed eyelid, wear contact lenses while there is inflammation, or apply remedies such as tea, garlic, chili, hot metals or oils, which have no scientific support and can irritate or infect.
A chalazion starts as an infection, but many factors are involved in the process, so antibiotic ointments or drops alone cannot always clear it. They are used when there is an acute infection or after surgery, always as prescribed by a doctor. In the office there are two direct options for a persistent bump: a corticosteroid injection into the lesion and surgical drainage. Do not self-medicate.[2][3]
If it does not improve with consistent compresses after a few weeks, or if it grows or bothers you, see a doctor. The ophthalmologist decides between continuing medical treatment, an injection or drainage, depending on size, location and how long it has been present.
When conservative treatment is not enough, Dr. Diener performs drainage and curettage of the chalazion, a brief outpatient procedure under local anesthesia. In practically all cases it is approached through the inner surface of the eyelid to avoid a visible scar on the skin. Afterwards, compresses, a topical medication and a follow-up visit are prescribed. Rest is generally needed only on the day of the procedure. Swelling and mild bruising usually fade within a few days. It can also be performed in children.[1][3]
A chalazion that always returns in the same place, comes with loss of eyelashes or thickening of the eyelid margin, or appears in an older person, can be mistaken for an eyelid tumor, which in rare cases looks like a chalazion. In those cases the tissue is sent for pathology. This is one reason to have it evaluated by an oculoplastic ophthalmologist rather than simply drained.[1][4]
Prior tests: an eyelid evaluation and, if the chalazion is recurrent or atypical, a review of possible underlying conditions.
Alternatives: warm compresses and massage, medications, or a steroid injection before surgery.
Risks: recurrence, mild bleeding, pigment changes and a minimal scar. Rarely, temporary eyelash loss.
If you have severe pain, spreading redness or significant vision loss, go to the emergency room.
General information; it does not replace a medical evaluation.
General information; it does not replace a medical evaluation.
How is a chalazion treated?
First, warm compresses for 10 to 15 minutes, at least four times a day, with gentle massage and cleaning of the eyelid margin. If it does not improve in a few weeks, the ophthalmologist can inject a corticosteroid or drain the chalazion.
What is the difference between a chalazion and a stye?
A stye is an acute, painful, warm infection at the eyelid margin. A chalazion is a firm, slow-growing, almost painless bump caused by a blocked meibomian gland.
How long does a chalazion last? Can it go away on its own?
Yes, many go away on their own in about a month with warm compresses, although some take longer. If it persists, grows or affects your vision, have it evaluated.
How can I get rid of a chalazion quickly?
There is no safe way to speed it up at home; consistent warm compresses help the most. If you need to resolve it sooner for vision or appearance, the doctor can inject or drain it in the office.
Which ointment, drops or medication works for a chalazion?
Antibiotic ointments or drops alone do not clear a chalazion; they are used if there is an associated infection or after surgery. A doctor should prescribe any medication.
What should I not do if I have a chalazion?
Do not squeeze, pop or prick it, do not wear makeup over the inflamed eyelid, and avoid home remedies such as tea or garlic, which can infect it or worsen the inflammation.
What can I do if the chalazion does not go away?
See a doctor. If it always returns in the same place or eyelashes are lost, the doctor may order a pathology study to rule out another eyelid lesion.
Does chalazion surgery hurt? Can it come back?
It is done under local anesthesia, so it should not hurt during the procedure. It can come back if there is blepharitis or meibomian gland dysfunction, so the underlying cause is treated as well.
