A chalazion is a small lump or swelling that forms on the eyelid, resulting from a blocked oil gland. These glands, called meibomian glands, produce oil that lubricates the eye surface. When the oil thickens or the gland opening narrows, the secretion gets trapped, causing inflammation and forming a firm nodule. Most chalazia are not caused by a bacterial infection, but rather by the inflammatory reaction to the trapped oil. The purpose of chalazion surgery is to mechanically remove the accumulated material when non-surgical treatments have failed to clear the blockage.
Why Surgery Becomes Necessary
A chalazion often resolves spontaneously over several weeks to a few months with conservative management. The first line of treatment involves applying warm compresses to the eyelid, typically for 10 to 15 minutes multiple times a day, to help soften the hardened oil blocking the gland. This is often combined with gentle eyelid massage to encourage the thickened secretions to drain naturally.
If the lump persists beyond a few weeks or causes significant symptoms, an ophthalmologist may consider a steroid injection into the lesion to reduce inflammation. Surgery is reserved for chalazia that are chronic and non-responsive to conservative treatment. A chalazion may also become a candidate for surgical removal if it is particularly large, causes cosmetic distress, or mechanically interferes with vision.
The Surgical Procedure Explained
The surgical removal of a chalazion, often referred to as an incision and curettage, is a minor procedure usually performed in an outpatient clinic. The procedure is performed under local anesthesia, which involves injecting a numbing agent directly into the eyelid tissue surrounding the chalazion.
Once the area is numb, a specialized clamp is placed over the lesion to stabilize the eyelid and control bleeding. To minimize visible scarring, the surgeon frequently everts the eyelid and makes a small incision on the inner surface, known as a transconjunctival approach.
After the incision is made, a small instrument called a curette is used to scrape out the trapped, solidified oily material and the inflammatory tissue lining the cyst cavity. If the chalazion is very large or located near the eyelid margin, an external incision may be necessary, which is typically closed with fine, dissolvable stitches. Following the removal of the contents, firm pressure is applied to the eyelid to ensure hemostasis before the patient is released.
What to Expect During Recovery
Immediately following the incision and curettage procedure, the eye is often covered with a pressure patch. This patch is usually kept in place for several hours or overnight. Patients will commonly experience some temporary effects, including mild discomfort, slight bruising, and swelling around the eyelid for several days.
The surgeon will typically prescribe antibiotic drops or ointment, which must be applied as directed, usually for up to a week, to prevent infection at the surgical site. A small amount of reddish fluid leakage from the incision site is normal for the first day or two. Applying a cold compress to the closed eyelid is often recommended for the first 24 to 48 hours to help reduce initial swelling.
Patients are advised to avoid activities that could introduce bacteria or irritate the healing eye, such as wearing eye makeup, using contact lenses, or swimming for one to two weeks. Most individuals can return to their normal daily activities, including work, within one or two days, provided their vision is not significantly blurry. While the incision site heals quickly, some residual swelling or a firm lump may take several weeks to fully subside.