Hello and welcome to Case of the Day. I’m Dr Croley and today we’re gonna discuss a case where a gentleman, a young man, came in today, complaining that he had a bump or lump on his upper lid and been there for approximately a month. It wasn’t really changing in size and so he wasn’t that concerned about it and it was only minimally tender to touch. When we examined him, he had what we call a chalazion.
A chalazion is a cyst that forms in the Meibomian glands in your eyelids. So you have set of glands on the upper and lower lid that secrete a lipid layer or the oily outer layer of your tear film and sometimes, they get plugged up and form a cyst. The cysts are usually not infected but they can be, in some cases, and people can have an infection inside the gland.
Something that’s similar but not exactly the same is called a stye or hordeolum and that is a little different and that is an infection in a sebaceous gland in your lid and that is an infection which is different from the chalazion, which may not be an infection and just a cyst. And so they’re treated similarly and they look very similar so it’s just truly a matter of medical terminology because you really sort of do the same thing for both.
There are occasions where people get chalazions where they do get bigger and bigger and bigger and become painful but a lot of times they happen and they form several hard nodules in the lid and they may stay there for an extended period of time.
The treatment, when someone initially comes in is, is that you can tell them they can try hot compresses. So we tell people to put like a washcloth, put in hot water, hot as you can stand without burning yourself, and you apply the compress to your eye. When it cools off, you put it back in the hot water and then put it back to your eye and keep your lid heated up for about 15 minutes and if you can do that four times a day that’d be great. Many times, that alone would take care of the chalazion and would resolve and go away especially if someone starts doing that early in the process. If they will not go away and it forms this nodule and something the patient doesn’t want or it is painful, they can occasionally cause blurred vision, that is the bump that’s on the upper lid is rubbing across when you blink, it rubs across your cornea and can distort your cornea and can actually blur your vision. So sometimes they’re removed because it’s blurring a person’s vision.
But, if it’s not gonna go away, then we go ahead and then operate it and clean and remove the cyst. And how do we do that? We take an injection of local anesthetic and put in into the eyelid, that’s the bad part of the procedure. Then we have a little clamp that we put on the lid. We actually flip the lid inside out and we make the incision on the inside of the eyelid. So the incision’s not on the outside of the lid but actually on the inside of the lid. So we open up the cyst and then we clean out the mucus and could be pus-like material out of the cyst. We have a little curette that has fine little teeth and we clean up that cyst area because if we don’t do that, the cystic wall of the remains could form a cyst again. We have to scrape and clean that out and get it cleaned. Then we put people on typically, an antibiotic eye drop for a week to ten days and have them continue hot compresses after the procedure. And better than 90 percent of the time, that procedure will get rid of the chalazia.
So chalazions [chalazia] are very common. People tend to get them. A lot of children get them, young people get them. And then it’s sort of, through the middle age we don’t see that quite as much and then as people get older they start to return sometimes, some people get them again.
Sometimes they’re associated with a disease called blepharitis, which is an infection or inflammation around the eyelashes, and that’s exactly where those little meibomian glands open. So if someone has chronic blepharitis of their eyelids, they typically have a lot more chalazions developed. So it’s important if you have blepharitis to keep your lids clean and that’ll keep the blepharitis under control.
So if you have any questions about a lump on somebody’s lid or chalazion, you can always contact us through the website. We’ll be happy to answer any questions. If not, may God bless you with healthy eyes and great vision.