Contents
Chronic sterile lipogranuloma caused by inflammation and obstruction of sebaceous glands of the eyelids.
Etiopathogenesis
While infection can cause the inflammation or obstruction that leads to a chalazion, the lesion itself is an inflammatory lesion.
- Deep chalazion: Caused by inflammation of a tarsal meibomian gland
- Superficial chalazion: Caused by inflammation of a Zeis gland
Chalazion is a conjunctival granuloma:
Inflammatory lesions that form when lipid breakdown products leak into surrounding tissue and incite a granulomatous inflammatory response
Presentation
Usually presents as a painless swelling on the eyelid for weeks or months.
- Impaired vision or discomfort
- Inflamed, painful, or infected lesion
Diagnosis
Chalazion is a clinical diagnosis
- Palpable, usually non-tender (though in acute inflammation there may be some associated tenderness), non-fluctuant, non-erythematous nodule on the eyelid.
Differential diagnosis:
- Hordeolum: Chalazia tend to be deeper within the lid than hordeolum. Hordeolum are usually tender, superficial, and centered on an eyelash.
Management
Conservative management:
- Warm compresses
- Lid massage
- Mild soap/shampoo
Antibiotic therapy:
Associated infectious etiology is suspected
- Tetracyclines or metronidazole
Steroid injection:
Surgical intervention:
Persistent lesions
- Recurrent chalazia should be biopsied to rule out sebaceous cell carcinoma.