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chalazion

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This is a retention cyst of the Meibomian gland. It may become infected or may develop into a sterile chronic lipogranulomatous inflammatory response in which case it is called a Meibomian cyst or Chalazion (1).

  • meibomian glands are modified sebaceous glands (which produce lipid material onto the tear film) which opens up behind the eye lashes (1)
  • retention and stagnation of the secretion results in obstruction of the gland duct
  • may occur spontaneously or may develop from an internal stye (2).

Predisposing factors for meibomian cyst include:

  • chronic blepharitis
  • rosacea
  • seborrhoeic dermatitis
  • pregnancy
  • diabetes mellitus (2)

A chalazion presents as a firm, painless, immobile, roundish lump in the tarsal plate which gradually enlarges (3).

  • these are well defined subcutaneous nodules of 2-8 mm in diameter
  • commoner in the upper eye lid (3)
  • usually single but more than one can be present (2)
  • pain may be seen if the chalazion enlarges and cause distension of sensory nerve endings (3) 
  • initially, it may resemble a stye but lacks acute inflammatory signs
  • the majority point towards the conjunctival surface which may be slightly reddened or elevated.

Occassionally, blurring of vision may occur from induced astigmatism due to direct pressure on the cornea (3).

A third of cases will resolve spontaneously and virtually all will resorb within two years.

  • warm compresses can be used to increase drainage of the affected duct
  • a gentle massage after warm compresses will help to express the contents of the cyst (3)
  • if conservative therapy fails
    • chalazions can be treated by surgical incision into the tarsal gland followed by curettage of the glandular material and glandular epithelium (1)
    • intralesional injection of steroids can be used (3)
  • infected cysts are treated as styes e.g. with topical antibiotics such as fusidic acid, application of hot compresses

Click here for example image of this condition

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