A chalazion is a common, non-infectious lump that can form on the eyelid due to a blocked oil gland. Understanding its causes and management can help address this persistent eyelid issue. This article provides insights into the development and treatments for chronic chalazia.
What is a Chalazion?
A chalazion is a non-infectious, inflammatory lump that develops on the eyelid. It forms when one of the small oil-producing glands in the eyelid, such as a meibomian or Zeis gland, becomes obstructed. These lumps enlarge slowly and are not tender to the touch.
A chalazion begins as a small, slightly tender, or swollen area on the eyelid before becoming a painless, slow-growing lump, sometimes reaching the size of a pea. A large chalazion can press against the eyeball, leading to blurred vision or mild irritation and tearing. A chalazion differs from a stye (hordeolum), which is an acute, often painful bacterial infection of an eyelid gland, appearing red and swollen closer to the eyelid’s edge.
Why Chalazia Form
Chalazia primarily form due to the obstruction of the sebaceous, or oil, glands within the eyelid. This blockage traps the gland’s secretions, leading to inflammation and the development of the characteristic lump. Certain conditions can increase an individual’s susceptibility to developing chalazia.
Common risk factors include chronic blepharitis, an ongoing inflammation of the eyelids, as well as rosacea and seborrheic dermatitis. Less common factors like low serum vitamin A, gastrointestinal inflammation, or Demodex mite infestations can also contribute. Eyelid trauma, certain viral infections, or face mask wear have been mentioned as potential associations, though the direct causal role of some factors, such as stress, has not been medically established.
Managing a Chalazion
Initial management of a chalazion begins with conservative home remedies. Applying warm compresses to the affected eyelid for 10 to 15 minutes, two to four times daily, can help soften the hardened oil blocking the gland. Gently massaging the eyelid for several minutes each day can also promote drainage. Maintaining good lid hygiene, possibly by using dilute baby shampoo on the eyelids, is another helpful measure. Most chalazia resolve within a month with these consistent conservative approaches.
If conservative measures are insufficient after a month, medical intervention may be necessary. Intralesional steroid injections directly into the chalazion can reduce inflammation and swelling. For persistent or larger chalazia, a surgical procedure involving incision and drainage may be performed to remove the trapped material. Less common treatments, such as topical antibiotic-steroid eye drops or injections of 5-fluorouracil, may be considered. Avoid attempting to squeeze or “pop” the chalazion, as this can cause further damage or complications.
Recurrence and When to See a Doctor
Chalazia can frequently recur, especially in individuals predisposed to them. A history of previous chalazia increases the likelihood of future occurrences. Seek professional medical evaluation if a chalazion does not resolve within approximately one month of consistent conservative treatment.
Medical consultation is also recommended if the chalazion causes significant discomfort, impairs vision, or recurs frequently in the same location. For recurrent chalazia, especially in older adults, a doctor will evaluate for more serious underlying conditions that can mimic a chalazion, such as sebaceous gland carcinoma, basal cell carcinoma, or other eyelid malignancies, which require prompt attention. In children or young adults, recurrent chalazia may prompt an evaluation for conditions such as viral conjunctivitis or hyperimmunoglobulinemia E syndrome. A thorough examination can confirm the diagnosis and rule out other potential causes.