Chalazion – a lump on the eyelid

There are various types of eye lid lesions. This information has been given to you to help answer some of the questions you may have about the chalazion, which is the commonest lump on the eyelids. If you do have any questions or concerns, please do not hesitate to speak to the doctor.

       

What is a chalazion?

A chalazion is a common lump on the eyelid that is caused by inflammation of a tiny gland within the skin. This gland produces oil. When this gland becomes blocked, it can rupture and the inflammation process begins. A chalazion is not a stye, which is an infection in the eyelash hair follicle root on the surface of the skin.

What are the signs and symptoms?

A hard, localised swelling appears on the upper or lower eyelid, occurring over a few weeks. It may be tender and the eyelid may appear red, if it is infected

What treatments are available?

No treatment may be necessary as up to half of people get better without any treatment. This can take between two and six months but if the chalazion is not causing you any problems, it is probably best just to watch and wait.

 

Hot compresses help to ease discomfort. Hold a clean flannel that has been in hot water gently but firmly against the closed eye for 5-10 minutes, 3-4 times a day. Sometimes this warmth and slight pressure is enough to soften the contents of the fluid-filled swelling (cyst), helping it drain more easily. (The water should be hot but comfortable and not scalding.)

 

Antibiotic ointments, drops and medicines are not recommended as they do not make any difference - the contents of the cyst are infection-free (sterile).

Massage of the cyst after using a hot compress can encourage the cyst to drain. Do this gently, with a clean finger or cotton bud, in the direction of the eyelashes.

 

Cleaning the eyelid twice per day removes grease and dead skin cells that may contribute to cysts forming. A weak solution of baby shampoo in warm water is ideal.

 

A small operation is an option if it is troublesome or persistent. Your GP can refer you to an eye surgeon (ophthalmologist) for this. The operation is usually done under local anaesthetic, although children and some adults may not tolerate this and may require general anaesthetic. The eyelid is numbed. A small cut is then made on the inside of the eyelid to release the contents of the cyst and it is scraped out. After surgery, antibiotic drops or ointment are commonly prescribed.

 

Instructions for hot spoon bathing:

We recommend that you have someone at home help you with this. The heat helps to relieve pain and encourages the lump to discharge.

  1. Pad the end of a wooden kitchen spoon with an absorbent material such as gauze or a flannel.

  2. Dip the spoon into a bowl of steaming water.

  3. Keeping the eye closed, raise the padded end to the affected eye, keeping it about an inch away from the eyelid.

  4. As the spoon cools, re-dip it into the steaming water and repeat step 3.

  5. Repeat for 10-15 minutes and do these two to three times daily.

 

Alternatively wring out a face towel with warm, boiled water and gently place it over the closed lid for 5 to10 minutes. Make sure the water is not too hot. Gently massage the area with your finger tips for two minutes, every morning and night for two weeks. This is particularly suitable for children.

 

What if hot spoon bathing does not work?

If the lump grows and is does not respond to hot spoon bathing or applying a warm face towel, you may need antibiotic drops or an ointment.  If the antibiotics don’t work you may need a small surgical procedure called ‘incision and curettage. Your doctor will explain this procedure if you need to have it. Please tell your doctor if you have any questions.

 

What happens if I do not get treatment?

Sometimes the lump disappears or shrinks by itself without treatment being needed. However, without treatment the lump may enlarge and the affected lid could swell – this could lead to more discomfort.

 

What should I do if the symptoms get worse?

Chalazion is not a dangerous condition and will not affect your sight unless your eyeball becomes red. If your symptoms get worse or do not go away with treatment after two weeks, please seek medical opinion. If you are worried about your symptoms outside of these hours, contact your GP or NHS Direct.

 

Are there any complications?

Most chalazia cause no problems. Rarely, a cyst can become infected and this infection can spread to involve the whole eyelid and tissues surrounding the eye. The eyelid may be very swollen and red. You might not be able to open the eye and you may have a lot of pain and a high temperature (fever). If you develop this type of complication, called orbital cellulitis, you need to see a medical professional urgently. Treatment of orbital cellulitis is with antibiotics, usually into a vein (intravenously) via a drip, in hospital.

 

Will it happen again?

For most people, a chalazion occurs just once. However, some people are prone to developing them and they may come back (recur). You may be able to prevent this by using a warm compress and other measures. Please discuss with your doctor about this. 

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