Chalazion

What is a Chalazion (pleural Chalazia)?

A Chalazion (pronounced “kah-LAY-ziun”) is a swelling in the eyelid caused by inflammation developing in one or more of the small oil producing glands (meibomian glands) located in the upper and lower eyelids. As with a pimple in the skin, the oil gland becomes blocked and oil leaks out into the tissue around the gland. The tissue becomes inflamed (not infected) as the white blood cells try to remove the oil.

Who is at risk of developing Chalazia?

Chalazia can occur in people of all ages and are very common
People with blepharitis
People with rosacea
It is not related to use of make-up, cleanliness or dirty environments

What are the symptoms of Chalazia?

The eyelid becomes red, swollen and painful initially. As the chalazion matures, a firm lump (like a small pea) may be felt developing in the eyelid. They pain often subsides and if the oil does not discharge completely then you are left with a non-tender lump in the eyelid. Vision is usually normal, however if the chalazion is large then it may cause distortion of the cornea and lead to blurry vision. This usually improves after the chalazion resolves.

How are Chalazia diagnosed?

Careful examination is necessary to identified all the blocked meibomian glands as there are frequently multiple chalazia, and the smaller ones may not be obvious when there are bigger ones. Any presence of blepharitis also needs to be identified. In the elderly, very rarely, sebaceous carcinoma can resemble a chalazion and this needs to be excluded with biopsy.

How are Chalazia treated?

When a chalazion is small it may disappear on its own. In the early stages using warm compresses to soften the oil and mild massage can help to unblock the gland, and any other blocked glands, allowing the oil to drain out. If a chalazion is going to resolve, it usually does so within the first few weeks. A longstanding, persistent and/or large chalazion may need to be drained (incision and curettage) to remove the oil build up and unplug the blockage of the oil gland opening.

Warm compresses

While a hot towel can be used, it usually cools down too quickly. A heat pack (containing gel or wheat) which can be heated up in the microwave retains heat better. These need to be hot enough to heat up the eyelids, but not so hot as to burn your skin. Hold the heat pack against the closed eyelid over 5 to 10 minutes, 3 to 4 times per day. You may notice some mucus or pus-like matter drain from the area. Continue to do this until the inflammation has resolved. Use in conjunction with eyelid massage.

Eyelid massage

Incision and curettage

In most cases the incision is made on the inside of the eyelid, but if the chalazion has burst through the skin, the scab on the skin of the lid will need to be removed.

Whilst you are lying down, local anaesthetic is injected into the affected eyelid to numb the area. This will sting for 30 seconds but is usually less painful than imagined.
When the eyelid is numb, a sterile instrument is placed onto the eyelid to protect the eye and isolate the chalazion. The eyelid is turned inside-out.
An incision is made into the chalazion through the back surface of the eyelid and the oily matter removed with a curette. The affected gland opening along with any other blocked oil glands are unblocked.
An eye pad will be placed on the eye temporarily to allow time for the bleeding to stop. This will be removed after 10-15 minutes. You will be able to drive yourself home. If you do have someone to drive you, you may wish to leave the eye pad on until the anaesthetic wears off.
In general, there is no need to have the chalazion contents examined by a histopathologist if the history, clinical findings, and material obtained appear consistent with a chalazion. In rare cases the material may be sent to the lab for analysis.

What to expect after incision and curettage?

It generally takes about two hours or so for normal feeling to return. During this time your blinking may be affected – it may seem slow or strange. For the first day or two, you can use ice-packs to help reduce the swelling and bruising.
There can be mild pain after the procedure. If you feel the need, paracetamol is usually sufficient.
You may notice swelling and bruising on the eyelids which may track downwards under the skin onto your lower eyelid / cheek. It will resolve over a few days to a week.
It is not uncommon to have blood-stained tears and significant clear or creamy, oily mucus in the first few days as residual matter drains from the opened gland/s. Depending on the amount of swelling and number of affected glands it can last up to a week. This does not indicate there is an infection.
It may take several weeks for the tissue to return to normal and for the lump to resolve, particularly if your chalazion has been present for a while.

What if a chalazion is not treated?

If the chalazion has been present for more than a month or so, it is unlikely to resolve by itself. It may remain static or fluctuate in size and symptoms if the meibomian gland builds up more oil and partially discharge repeatedly. This is uncomfortable but does not tend to cause any damage to your eye or vision.

How to prevent future chalazia?

There is no specific treatment that can completely eliminate the risk of you developing more chalazia in the future. Daily hot compress and massages of the eyelids, even when there is no chalazion present, can improve the function of the meibomian glands and make them less likely to block.

This is particularly important for people with blepharitis. A supplement of fish oil and flax seed oil may also be beneficial.

Eye conditions we treat

Explore the range of eye conditions we can help manage and treat for better vision and eye health.

see all eye conditions