Chalazion and Stye, management options you must know before surgery.

What is Chalazion?

Chalazion is a common eyelid condition characterized by the development of a painless, localized bump or swelling. It occurs when the oil-producing glands (meibomian glands) in the eyelids become blocked and inflamed.

Chalazion vs Stye

Chalazion	Stye
Non-infectious	Infectious
Formed due to blockage of oil glands	Caused by bacterial infection
Painless, usually not tender	Painful, often tender to the touch
Develops gradually over time	Develops rapidly
May be larger in size	Typically smaller in size
Located away from the eyelash base	Located at the eyelash base
Usually not associated with redness	Redness and swelling are common
May persist for weeks or months	Often resolves within a few days
Treatment involves warm compresses, gentle massage, and good eyelid hygiene	Treatment may include warm compresses, antibiotic ointments, or oral antibiotics depending on severity
Surgical intervention may be necessary if the chalazion does not resolve with	Surgical intervention is generally not required conservative measures

Top 5 causes of recurrent Chalazion:

1. Meibomian Gland Dysfunction: Meibomian glands, located along the eyelid margins, produce an oily substance that helps lubricate the eyes. Dysfunction of these glands, often due to blockage or inflammation, can lead to recurrent chalazion formation.
2. Blepharitis: Chronic inflammation of the eyelid margins, known as blepharitis, can contribute to the development of chalazia. Blepharitis can be caused by bacterial or skin-related conditions and may require ongoing management to prevent recurrence.
3. Poor Eyelid Hygiene: Inadequate eyelid hygiene, such as infrequent cleansing or improper removal of eye makeup, can increase the risk of chalazion recurrence. Maintaining good eyelid hygiene is important to prevent the accumulation of debris and oil gland blockage.
4. Preexisting Skin Conditions: Certain skin conditions, such as rosacea, seborrheic dermatitis, or acne, can be associated with an increased risk of chalazion formation. The underlying inflammation and oil gland dysfunction in these conditions can contribute to recurrent chalazia.
5. Systemic Factors: In some cases, systemic factors such as hormonal imbalances or immune system disorders may contribute to recurrent chalazion formation. Conditions like diabetes, thyroid disorders, or autoimmune diseases may impact the health of the oil glands and increase the likelihood of chalazion recurrence.

What are the indications for chalazion surgery?

Indications for chalazion surgery may include:

1. Persistent Chalazion: If a chalazion does not resolve or becomes larger despite conservative treatments, such as warm compresses, eyelid hygiene, and medication, surgical intervention may be recommended.
2. Functional Impairment: Chalazia that interfere with vision, cause significant discomfort, or affect daily activities like blinking or closing the eyelid may require surgical removal.
3. Recurrent Chalazia: Individuals who experience frequent or recurrent chalazia, even after conservative treatments, may benefit from surgery to prevent further episodes.
4. Cosmetically Concerning: Chalazia that are cosmetically bothersome, especially when located in prominent areas, such as the eyelid margin or near the lash line, may be surgically removed for aesthetic reasons.
5. Risk of Complications: In some cases, a chalazion may pose a risk of complications, such as secondary infection or inflammation spreading to surrounding tissues. Surgery may be recommended to address these concerns.

What are the types of Chalazion Surgery?

There are different types of surgical procedures that can be performed to treat chalazion. The choice of surgical technique depends on various factors, including the size and location of the chalazion, individual patient characteristics, and surgeon preference. Here are some common types of chalazion surgery:

1. Incision and Curettage: This is the most common surgical approach. It involves making a small incision on the inside of the eyelid or the back surface of the eyelid and then using a curette (a small spoon-shaped instrument) to scrape out the contents of the chalazion. Local anesthesia is typically used for this procedure.
2. Intralesional Steroid Injection: In some cases, especially for smaller chalazia, an injection of a corticosteroid medication may be administered directly into the chalazion. The steroid helps to reduce inflammation and promote resolution of the chalazion.
3. Chalazion Excision: For larger or more complex chalazia, surgical excision may be performed. This involves making an incision on the outside of the eyelid and completely removing the chalazion along with its surrounding tissues. Local anesthesia is used, and sutures may be required to close the incision.
4. Laser-Assisted Chalazion Surgery: Laser treatment can be used as an alternative to traditional surgical techniques. It involves using a laser to make an incision and then removing the chalazion through that incision. Laser-assisted surgery may offer advantages such as reduced bleeding and faster healing.

The specific surgical approach chosen will depend on the individual case and the expertise of the surgeon. Your eye care professional will evaluate your condition and recommend the most suitable surgical technique for your chalazion. It’s important to follow your surgeon’s instructions and attend any necessary follow-up appointments for a successful recovery.

Precautions Before and after chalazion surgery

Before Surgery:

1. Consultation: Schedule a consultation with your eye surgeon to discuss the procedure, potential risks, and recovery process.
2. Medication Review: Inform your surgeon about any medications you are currently taking, including prescription drugs, over-the-counter medications, and supplements.
3. Fasting: Follow any fasting instructions provided by your surgeon, such as refraining from eating or drinking for a specific period before the surgery, if necessary.
4. Arrange Transportation: Plan for transportation to and from the surgical facility, as you may not be able to drive immediately after the procedure.
5. Hygiene: Ensure good eyelid hygiene by keeping the area clean and avoiding the use of eye makeup or creams on the day of surgery.

After Surgery:

1. Follow Post-Operative Instructions: Carefully adhere to the post-operative instructions provided by your surgeon, including any prescribed medications, eye drops, or ointments.
2. Rest and Recovery: Plan for adequate rest and recovery time following the surgery, as your eye may be sensitive, and you may experience temporary blurred vision.
3. Avoid Touching or Rubbing: Refrain from touching, rubbing, or squeezing the operated area to prevent infection or disruption of the healing process.
4. Protect the Eye: Use protective eyewear, such as sunglasses or an eye shield, as advised by your surgeon, to shield the eye from dust, sunlight, and potential injury.
5. Avoid Makeup: Avoid using eye makeup, creams, or lotions around the eye area until your surgeon advises it is safe to do so.
6. Follow-Up Appointments: Attend all follow-up appointments with your surgeon to monitor the healing progress and address any concerns or complications.

What if Blepharitis coexist with chalazion and stye?

If blepharitis coexists with chalazion and stye, it can complicate the management and treatment of these conditions. Blepharitis is a chronic inflammation of the eyelid margins, while chalazion is a blocked oil gland, and stye is an infected eyelid gland. These conditions can be interrelated and share common underlying causes, such as poor eyelid hygiene, bacterial overgrowth, or dysfunctional oil glands.

When blepharitis coexists with chalazion and stye, it is important to address all three conditions simultaneously to achieve optimal treatment outcomes. Here are a few considerations:

1. Eyelid Hygiene: Maintain proper eyelid hygiene by regularly cleaning the eyelids and lash margins with a mild cleanser or prescribed eyelid scrub. This helps remove debris, bacteria, and excess oil that contribute to blepharitis, chalazion, and stye formation.
2. Warm Compresses: Apply warm compresses to the affected area to help soften any chalazion and promote drainage. Warm compresses also help soothe the eyelids and reduce inflammation associated with blepharitis.
3. Medications: Depending on the severity of the conditions, your eye care professional may prescribe topical or oral medications. These can include antibiotic ointments or drops to treat any infection, anti-inflammatory medications to reduce inflammation, or artificial tears to alleviate dryness associated with blepharitis.
4. Follow-Up Care: It is important to have regular follow-up appointments with your eye care professional to monitor the progress of all three conditions. They can assess the response to treatment, make any necessary adjustments, and provide guidance on long-term management and prevention strategies.

Managing the coexistence of blepharitis, chalazion, and stye may require a comprehensive approach and individualized treatment plan. Working closely with an eye care professional will ensure that appropriate measures are taken to address all contributing factors and promote healing and overall eye health.

1. Warm Compresses: Applying warm compresses to the affected eyelid can help soften the blockage, promote drainage, and reduce inflammation. Soak a clean cloth in warm water and place it gently over the closed eyelid for 10 to 15 minutes, several times a day. Repeat this process for several days or until the chalazion resolves.
2. Gentle Massage: After applying a warm compress, gently massaging the affected eyelid can help promote the drainage of the blocked gland. Use clean hands or a clean cotton swab and gently rub the area in a circular motion. Be careful not to press too hard to avoid causing further irritation.
3. Eyelid Hygiene: Maintaining good eyelid hygiene is crucial for preventing chalazion and reducing the risk of recurrence. Cleanse your eyelids regularly using a mild, non-irritating cleanser or baby shampoo diluted with warm water. Use a clean washcloth or cotton pad to gently clean the eyelid margin.
4. Over-the-Counter Remedies: Some over-the-counter ointments or drops containing ingredients like hydrocortisone or artificial tears may help reduce inflammation and alleviate symptoms. However, it’s important to consult with an eye care professional before using any medication to ensure its safety and appropriateness for your specific case.
5. Avoid Eye Makeup: During the healing process, it is advisable to avoid wearing eye makeup or using any cosmetic products that may further irritate the eyelids.
6. Avoid Eye Rubbing: Refrain from rubbing or touching the affected eye, as it can worsen inflammation and potentially spread the infection.
7. Seek Medical Evaluation: If the chalazion persists or causes significant discomfort, it is recommended to seek medical evaluation from an eye care professional. They may prescribe additional treatments or procedures, such as steroid injections, incision and drainage, or the use of antibiotic ointments.

Conclusion

It’s important to note that while these strategies and home remedies can often help manage chalazion, they may not be effective for everyone or in more severe cases. If the chalazion does not improve or if it causes significant discomfort or affects your vision, it’s best to consult with an eye care professional for a proper evaluation and personalized treatment plan. They can provide appropriate guidance and intervention to ensure the best outcome for your specific situation.

Resources

1. Aycinena AR, Achiron A, Paul M, Burgansky-Eliash Z. Incision and Curettage Versus Steroid Injection for the Treatment of Chalazia: A Meta-Analysis. Ophthalmic Plast Reconstr Surg. 2016 May-Jun;32(3):220-4. doi: 10.1097/IOP.0000000000000483. PMID: 26035035.