All You Need to Know About Chalazion
A chalazion, also known as a chalazion, is a cyst in the eyelid. This is caused by inflammation of a blocked gland on the upper eyelid. A chalazion differs from a stye (hordeola) in that it is a subacute and usually painless nodule.
What is a hailstone?
The glands affected by a chalazion are the meibomian or eyelid glands located in the eyelid. There are between 30 to 40 of these oil glands in each of the upper and lower eyelids. They produce a thick fluid that is contained in the eye’s tear film and lubricates the surface of the eye.
A chalazion is the result of a swollen oil gland in the eyelid caused by chronic inflammation after the gland duct becomes blocked. While the cyst tends to grow larger than a stye, once it swells it is painless and considered harmless.
Adults are more likely to suffer from a chalazion than children. Recurrent chalazia in the same location can sometimes be a symptom of sebaceous carcinoma, a rare type of cancer.
A chalazion is the result of an inflammatory process. The small opening through which a meibomian gland secretes its secretions can become blocked as a result of narrowing of the opening or hardening of the sebum near the opening.
The backflow thickens the walls of the gland and the escaping secretion in the eyelid itself. This leads to inflammation both within the gland and on the eyelid and ultimately to the formation of a cyst (chalazion).
A possible cause of a chalazion is incomplete removal of eye makeup, which collects the oil from the cosmetic product in the glands.
Inflammation of the edge of the eyelid ( blepharitis ) as a result of the overproduction of sebum due to meibomitis or inflammatory skin diseases such as acne vulgaris or acne rosacea can also cause a chalazion.
Symptoms, Ailments & Signs
A chalazion is a prominent lump on the eyelid. Externally, it resembles the stye, but unlike the latter, it is usually not painful. Unlike this, the course is not acute either, but it develops gradually over several weeks and grows slowly. It is characteristic of the hailstone that it can be moved.
The chalazion is usually about the size of a hailstone, which is why it is also called that. In some cases, much smaller chalazia also occur. The simultaneous presence of several hailstones is unusual. A chalazion does not usually cause any pain, but it can be associated with an uncomfortable feeling of pressure in the eye that can be caused by the friction.
This can sometimes cause eye irritation and inflammation of the conjunctiva ( conjunctivitis ). The affected eye is clearly reddened. There may be increased sensitivity to light and increased tears. In rare cases, hailstones can also be large enough to impair vision. Without treatment, the hailstone usually disappears completely within a few months or years.
Diagnosis & History
Symptoms of the development of a chalazion are swelling of the eyelid combined with sensitivity to pressure, sensitivity to light or a perceived heaviness of the eyelid.
A bump appears clearly on the eyelid. A chalazion usually occurs in the upper eyelid. Smaller chalazions disappear over time, while larger chalazions become permanent or even increase in size.
Enlarged chalazia can increase pressure on the eyeball and cause visual disturbances. There is also a risk that the blocked gland will become secondarily infected, leading to irritation, pain and inflammation. For the relatively unambiguous diagnosis, the eyes are checked with regard to visual function and field of vision.
In order to reliably distinguish between a chalazion and a stye, the doctor treating you will also close the affected eyelid to examine the inside. In addition, a palpation examination will check the mobility of the chalazion.
A hailstone is usually not much larger than a grain of rice and only needs to be treated with eye drops or ointment in the case of severe inflammation. Very often it regresses on its own without any complications, which does not require any further measures. In some cases, however, it can swell. Then the chalazion endangers vision and an operation is necessary to remove the tissue knot.
Larger hailstones otherwise persist for a long time without swelling. Complications with the conjunctiva can also occur. Surgery is not done until the chalazion is causing severe pain or is larger than normal. Rare complications are also possible here. While most of those affected no longer have any symptoms a few days later, postoperative bleeding and infections cannot be ruled out, as is the case with any operation.
Damage to the optic nerve or the eye itself during surgery is also possible. Sometimes a scar also remains, causing the eyelid to warp. Normally, no traces of the operation remain on the eye. Recurring inflammation can indicate underlying diseases such as diabetes mellitus or other metabolic diseases and must be examined accordingly.
When should you go to the doctor?
Normally, a hailstone does not require medical treatment. It is a harmless inflammation of the eye glands that heals on its own after a few days. If the symptoms have not subsided after a week at the latest, a visit to the family doctor or ophthalmologist is indicated.
Accompanying symptoms such as severe pain, pus formation or visual disturbances also require medical treatment in order to avoid the development of serious complications. If another hailstone forms after treatment, a comprehensive investigation is required in any case.
The symptoms may be due to an allergy or a serious medical condition that needs to be diagnosed and treated. In individual cases, a lid tumor can develop from recurring inflammation. Therefore, recurring complaints should be examined by a specialist.
Patients at risk, such as people with chronic eye diseases, allergy sufferers, children, the elderly and pregnant women, are best advised to have a hailstone clarified immediately by their general practitioner. Other contacts are the ophthalmologist, the naturopath and, in the case of severe symptoms, the medical emergency service.
Treatment & Therapy
Treatment will initially be non-invasive. A hot compress can be applied to the affected area or massaged lightly to get the glandular secretions flowing again. Likewise, homeopathic remedies are excellent for treatment.
If antibiotic eye drops or eye ointment such as chloramphenicol or fusidic acid do not clear up a chalazion, surgical intervention is recommended. Removal of a chalazion is an outpatient procedure that usually takes no more than 15 minutes. Due to the risk of infection and serious damage to the eyelid, such procedures should be performed exclusively by a doctor.
The eyelid is numbed with a local anesthetic. A clamp is then placed over the eyelid to hold it securely in place and allow it to be flipped over. The doctor will then make a 3mm incision on the inside of the eyelid to scrape out the chalazion.
Since scarring of the eyelid can cause vision problems, surgery will only be considered as a last resort. Although chalazias are rarely dangerous, it is common for pieces of tissue to be sent in for biopsy for cancer screening.
Outlook & Forecast
The prognosis of a hailstone is favorable. The small or medium-sized hailstones usually completely regress within a few weeks. There are no consequential damages or impairments. Many patients suffer from the visual blemish caused by a hailstone. The emotional state of the affected person usually improves as the foreign body subsides.
Large hailstones temporarily impair vision. Since the eyelid cannot be moved as usual, the affected person’s field of vision is severely limited. Many doctors recommend surgery in these cases. If the patient decides to have the chalazion removed surgically, it is usually considered symptom-free afterwards. If no further complications or delays in the healing process occur, the patient is released from treatment after a few days as cured.
The eyelid can be opened as usual after the wound has healed. With this, the ability to see is completely restored, since the presence of a hailstone has no effect on the functionality of the eyeball or the information processing of the incoming sensory stimuli. Only the field of vision is restricted by the foreign body.
If a hailstone occurs again in the course of life, the prognosis is also favourable. The course of the disease and the treatment options remain unchanged in the event of a recurrence.
Thorough eye hygiene is recommended to prevent hailstones. This includes thorough make-up removal and cleaning of the eyelashes as well as meticulous cleaning of required contact lenses. In principle, strengthening the immune system also helps to counteract inflammatory processes.
In most cases, the person affected with a chalazion has no special or direct measures and options for aftercare. However, these are not necessary either, since it is a harmless disease that usually disappears on its own without the need for treatment. However, if the chalazion occurs for a longer period of time and does not disappear on its own, an ophthalmologist should be consulted.
This can possibly prevent further complications and complaints, which in the worst case would lead to the patient being completely blind. A chalazion can be treated relatively well with eye drops or an eye ointment. These drugs should be used regularly and in the right dosage. If anything is unclear or if you have any questions, always consult a doctor.
If the chalazion does not go away on its own through self-help measures and resources, a doctor should be consulted immediately. The affected eye should be particularly well protected in the case of a chalazion. Eyes are particularly important to protect after an operation. As a rule, this disease does not reduce the life expectancy of the affected person. Furthermore, aftercare measures are no longer necessary.
You can do that yourself
A hailstone can be treated very easily with just a few measures. In order to loosen the accumulation of secretion, it is recommended to apply a warm compress. The heat widens the pores and allows the secretion to drain. Disinfecting and anti-inflammatory plant extracts can also be added to the warm water: These include sage, cistus and chamomile.
If the inflammation spreads to the rest of the eye, eye drops can also be used. Antibiotics are usually not necessary. Eye drops are commercially available with hyaluronic acid – this ensures long-lasting moisturizing – or based on the plant eyebright. Euphrasia – as it is called in Latin – is offered in the form of ampoules or globules. It can be used internally and externally. The intake of selenium – an anti-inflammatory micronutrient – also provides useful internal support.
If the chalazion does not heal and there is a risk of scarring, you need to see an ophthalmologist or surgeon. This would remove the chalazion in an outpatient procedure. However, due to the risk of infection, this is the last resort for treatment.
As a preventative measure, eye make-up should always be removed thoroughly. Thorough hygiene also applies to used contact lenses. In order to care for the edges of the eyelids, those affected can resort to completely natural means: Olive or coconut oil have a disinfecting and caring effect at the same time.