A chalazion is a small, typically painless lump that forms on the eyelid when a meibomian gland becomes blocked. These glands produce oil to lubricate the eye, and when clogged, the oil builds up, causing a firm swelling. Chalazia are common eyelid conditions that usually resolve on their own over a few weeks to a month without specialized medical intervention.
Non-Surgical Treatment Options
Initial management focuses on conservative approaches designed to soften thickened oil secretions and encourage the blocked gland to drain naturally. The simplest home remedy is the application of warm compresses. A clean washcloth or commercial eye mask soaked in warm water should be placed on the closed eyelid for 10 to 15 minutes. Repeat this process four to six times daily to maintain the warmth needed to melt the trapped material.
Following the warm compress, gentle massage of the affected eyelid can help push the oily fluids out of the gland. Using a clean finger, apply light pressure in the direction of the eyelashes—downward for the upper lid and upward for the lower lid—for several minutes. Maintaining good eyelid hygiene, such as using a mild cleanser, also supports the healing process by clearing away excess oil and debris.
If conservative treatments do not resolve the chalazion after several weeks, a physician may recommend medical management. Although chalazia are typically not caused by a bacterial infection, antibiotics may be prescribed if an infection is suspected. Oral antibiotics, such as doxycycline, are sometimes used for their anti-inflammatory properties to reduce swelling and help the blockage drain.
An intralesional steroid injection, typically performed by an ophthalmologist, is a less invasive option than surgery. This procedure involves injecting a small amount of corticosteroid directly into the chalazion. The steroid acts as an anti-inflammatory agent, helping to shrink the lump and allowing the body to reabsorb the trapped contents. Studies show this single injection, followed by massage, can be nearly as effective as surgical removal for smaller lesions.
Specialists Qualified for Removal
When non-surgical methods fail, or if the lump affects vision or causes cosmetic concern, professional removal is considered. The primary specialists qualified to perform chalazion removal are ophthalmologists. An ophthalmologist is a medical doctor specializing in comprehensive eye and vision care, including medical and surgical treatment of eye diseases.
For complex or recurrent cases, an oculoplastic surgeon is highly specialized. This ophthalmologist completes additional fellowship training focused specifically on the eyelids and surrounding facial structures. Their expertise is valuable for removals that require precision to ensure a good cosmetic outcome and preserve eyelid function.
While optometrists focus on diagnosis, vision correction, and non-surgical management, they are often the first point of contact for a chalazion. They manage initial conservative treatment but typically refer patients to an ophthalmologist for surgical removal or steroid injection. Primary care physicians or dermatologists can also diagnose the condition and initiate home care, but they refer to an eye specialist for any procedure involving incision or injection.
The Surgical Removal Procedure
The standard surgical procedure for a persistent chalazion is called incision and curettage (I&C). This minor operation is typically performed in the ophthalmologist’s office or an outpatient clinic setting and takes about 10 minutes. The area around the chalazion is numbed using a local anesthetic injected directly into the eyelid before the procedure begins.
The surgeon uses a specialized instrument called a chalazion clamp to evert the eyelid, exposing the inner surface where the gland is located. Making the incision on the inside of the eyelid, rather than the outside, prevents a visible scar on the skin. A small vertical incision is made over the lump, following the natural orientation of the meibomian glands.
A small, spoon-shaped instrument called a curette is inserted through the incision to scrape out the contents of the cyst. Once drained, the clamp is removed, and pressure is applied to the eyelid to control bleeding. An antibiotic ointment is usually applied, and a firm eye pad may be placed over the eye for several hours to minimize swelling and bruising.
Patients can expect mild soreness, swelling, and bruising for several days after the procedure. The healing process usually takes one to two weeks, and patients are advised to avoid wearing contact lenses or eye makeup for a week. A biopsy of the removed tissue may be necessary if the chalazion is recurrent, unusually placed, or displays atypical characteristics, to rule out a more serious condition.