Chalazion - Causes, Symptoms, Diagnosis, Risk Factors, and Management

Introduction

A number of small swellings are bound to occur in and around the eyes. It is different from the swollen eyes seen after a good sleep. These swellings can be caused due to various bacterial, viral, and fungal infections, injuries, and burns.

Chalazion is red bumps seen on the eyelids, especially on the upper lids. It is found to be caused by the obstruction of meibomian oil glands, from where it also gets its other name - meibomian cyst. Their incidence in children is rare and is most commonly seen in people between the ages of 30 and 50. If more than one chalazion is present, it is called a chalazia.

Chalazion and styes are different. A stye is a painful red pimple-like structure and is of two types - internal and external. Chalazion is generally not painful, and it might occur because of a stye.

What Are the Causes of Chalazion?

Chalazion or the meibomian cyst is found to be caused by the blockage of meibomian oil glands. Meibomian glands are present along the edges of the eyelids and are responsible for secreting oil, which helps to lubricate the eye surface and prevents the eyes from drying out.

There are few other underlying medical conditions that can influence the chalazion to occur, and they are,

• Tuberculosis (TB) - Tuberculosis is a lung infection caused by Mycobacterium tuberculosis.

• Rosacea - Rosacea is a skin condition characterized by the presence of a flushing face and bumps like acne.

• Seborrheic Dermatitis - Seborrheic dermatitis is a common skin condition characterized by the presence of scaly patches and red skin, predominantly on the scalp. Dandruff is a common symptom.

• Blepharitis - It is the inflammation of the margins of the eyelids and shows symptoms like eyelid crusting, burning and irritation, blurred vision and photosensitivity (sensitive to light).

What Are the Symptoms of Chalazion?

• A red bump, usually painless, will be seen along the edges of the upper eyelid and occasionally the lower eyelid.

• The vision can be interrupted if the chalazion swelling is large enough to press against the eyeball. Blurred vision is a common symptom.

• Watery eyes will be present due to mild irritation caused by chalazion.

What Are the Possible Complications of Chalazion?

• Loss of eyelashes.

• Lid notching.

• Hordeolum - Red bump found over the edges of the eyelid.

What Are the Risk Factors of Chalazion?

The following conditions are found to be risk factors for chalazion.

• Viral Conjunctivitis - Inflammation of the conjunctival layer of the eye caused by adenovirus.

• Seborrheic dermatitis.

• Rosacea.

• Infection of the eyelid.

• Meibomian gland dysfunction.

• Chronic blepharitis.

How to Diagnose Chalazion?

• The ophthalmologist will take a thorough case history to know the origin of the condition and check if any medical conditions are causing it.

• A proper examination of the internal and external surfaces of the eyelid will be done to analyze the surface of the eyelid, texture, and eyelashes.

• Using a special instrument that provides bright light and magnification, the baseline of the eyelashes and the openings of the oil glands will be evaluated.

A proper diagnosis is critical in order to treat the conditions. Since this chalazion condition can mimic various conditions, diagnosis should be made precisely.

What Are the Possible Differential Diagnoses of Chalazion?

The chalazion can be mistaken for the following conditions.

• Sebaceous Cell Carcinoma - It is a type of tumor associated with glands of the eye like meibomian, glands of Zeis, etc.

• Basal Cell Carcinoma - It is characterized by the presence of a red nodule along the line of the eyelids and is more prevalent in males.

• Squamous Cell Carcinoma - It is the second most predominant tumor of the eyelid and appears like pale or red lesions. It is usually painless.

• Dacryocystitis - It is the blockage of the nasolacrimal duct and is caused by the infection of the lacrimal sac into which the tears generally drain.

• Molluscum Contagiosum - It is a viral infection of the skin of the eyelid characterized by the presence of dome-shaped or a pearl-shaped pink-colored bump. It usually resolves in some time, but might occasionally require excision and curettage.

• Herpes Zoster - Also known as ophthalmic zoster, is caused by varicella zoster virus and is characterized by the presence of redness and swelling of the eyes.

• Xanthelasma - It is seen as yellow bumps on the eyelids due to the accumulation of fats under the skin surface.

• Xanthogranuloma - It is a disorder in children affecting the skin.

• Blepharitis.

How to Manage Chalazion?

Chalazion can be treated with both home remedies and medications.

Home Remedies

• Warm Compresses - Warm compresses are found to provide good relief for chalazion. Warm compresses can relieve the hardened oil from blocking the gland. Thus, the duct clears up and drains.

To make warm compresses, soak a tidy cloth in warm water. Once the excess water is squeezed out, place it on the eyelid for 15 minutes and continue doing the same several times a day until the swelling subsides.

• Gentle Massages - Once the warm compresses are done, gentle massages can be done over the site to help the glands drain effectively. Using clean and tidy fingers is essential in order to avoid any infection from germs.

Medications

Medications are rarely needed in this condition unless other conditions like rosacea are present.

Low doses of tetracycline, doxycycline, or metronidazole as a six-month course will be needed and are found to provide great results.

How to Prevent Chalazion?

Following good hygiene is mandatory to prevent chalazion from occurring.

• It is essential to wash hands thoroughly before touching the eyes.

• Removing dirt and makeup from the face, especially around the eyes, is essential. Using appropriate scrubs and washes as advised by the doctors is advised.

• Before removing the contact lenses from the eyes, hands should be cleaned well.

• Using expired makeup products is a strict no, and should be very careful with that.

Conclusion

A chalazion is not dreadful; it usually resolves with home remedies and rarely requires medicines. Following good hygiene is essential to stay away from chalazion. In case the condition does not go away with home remedies, make haste to consult with an ophthalmologist to prevent any complications associated with it.