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Ocular System

Chalazion

Chronic sterile lipogranuloma caused by inflammation and obstruction of sebaceous glands of the eyelids.

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
Eyelid affected by a chalazion
Eyelid affected by a chalazion | Michal Klajban – CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=11037123

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.
© Jorge Muniz, MedComic

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.

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