Eyelids — Common condition

Chalazion: treatment and incision

A chalazion is an inflammatory cyst of the eyelid, common and benign. When it persists, an incision under local anaesthetic at the office allows it to be treated effectively.

What is a chalazion?

A chalazion is a cyst formed by the blockage of a Meibomian gland, a sebaceous gland located within the thickness of the eyelid. The blockage causes a build-up of sebum and a localised inflammatory reaction, which appears as a firm, barely painful nodule under the skin of the eyelid.

It differs from a stye, which is a painful bacterial infection of a hair follicle or a gland of the eyelid. A chalazion is generally barely painful and develops slowly. It may resolve spontaneously within a few weeks, or persist and require treatment.

Symptoms and progression

  • Firm nodule under the skin of the upper or lower eyelid, usually barely painful
  • Localised swelling that may distort the appearance of the eyelid
  • Visual disturbance in the case of a large chalazion pressing on the cornea
  • Conjunctival redness visible on the inner surface of the eyelid

Treatment

Initial medical treatment

As a first-line approach, daily eyelid massage combined with warm compresses helps promote spontaneous resolution. Anti-inflammatory eye drops or ointments may be prescribed in the case of active inflammation.

Incision at the office

When the chalazion persists beyond 4 to 6 weeks despite medical treatment, or when it is large and bothersome, an incision and curettage is offered. The procedure is performed at the office, under local anaesthetic by intra-eyelid injection. The eyelid is turned over and the cyst is incised then curetted through the inner surface — without any scar visible on the outside.

Duration — 10 to 15 minutes
Anaesthesia — Local by injection (eyelid)
Recovery — Transient swelling for 24 to 48 h, no sutures on the outer side
Available — Cachan office and Paris 13 office

In the case of a recurrent or atypical chalazion, a histological analysis of the contents may be requested to rule out a rare tumoural condition of the eyelid (sebaceous carcinoma).

Why does a chalazion appear ?

A chalazion results from the blockage of a Meibomian gland, whose role is to produce the oily part of the tears. Several factors favour this blockage :

  • A chronic blepharitis (inflammation of the eyelid margin) that thickens the secretions
  • A rosacea or seborrhoeic dermatitis, frequently associated
  • A Meibomian gland dysfunction, made worse by time spent in front of screens
  • Insufficient eyelid hygiene, which favours the stagnation of sebum

Chalazion or stye : how to tell them apart ?

These two eyelid conditions are often confused, but their nature differs. A stye is an acute bacterial infection, painful and red, centred on an eyelash ; it develops quickly and may form a point of pus. A chalazion, on the other hand, is a non-infectious inflammatory reaction, barely painful, that develops slowly as a firm nodule. A poorly resolved stye may, moreover, turn into a chalazion.

Prevention : eyelid hygiene

When a patient has recurring chalazia, regular eyelid care reduces the risk of recurrence : daily application of warm compresses, gentle massage of the eyelid margin and cleansing with a suitable product. Treating an underlying blepharitis or rosacea is an integral part of prevention.

When to see a doctor ?

It is advisable to seek advice when an eyelid nodule persists beyond two to three weeks despite warm compresses, when it grows in size, interferes with vision, or recurs regularly in the same spot. The consultation makes it possible to confirm the diagnosis, rule out a stye or another lesion, and propose the most suitable treatment.

Frequently asked questions

No, a chalazion is a benign lesion. It does not threaten vision, except when it becomes very large and presses on the cornea, which can induce temporary astigmatism. An atypical lesion, or one that always recurs in the same spot, nonetheless warrants a specialist opinion to rule out a rarer cause.

A stye is an acute infection of an eyelash follicle, painful, red, located at the eyelid margin and developing quickly. A chalazion is a non-infectious inflammation of a blocked Meibomian gland, deeper, less painful and developing slowly. The two can look alike at first, and a neglected stye may give way to a chalazion.

No. The majority of chalazia resolve with medical treatment (compresses, massage, sometimes eye drops). An incision is only considered when it persists for several weeks or remains bothersome.

The incision is made through the inner surface of the eyelid, with no scar visible on the outside. Transient swelling for 24 to 48 hours is usual.

An antibiotic and anti-inflammatory eye drop or ointment is generally prescribed for a few days. Swelling and a small bruise of the eyelid are common over the first 24 to 48 hours. Avoid rubbing the eye and eye make-up during healing ; vision is not affected.

Chalazia tend to recur on a background of blepharitis or Meibomian gland dysfunction. Regular eyelid hygiene (warm compresses then massage of the eyelid margin) clearly reduces the risk. In the case of repeated recurrences in the same spot, a specialist opinion is recommended.

Consultation & Incision

Treating a chalazion

Incision and curettage at the office — Cachan (94) and Paris 13. Quick procedure under local anaesthetic, without hospitalisation.

Cachan — Doctolib
Paris 13 — Doctolib

Related topics

  • Pterygium — another lesion of the ocular surface.
  • Dry eye — a common discomfort of the eye surface.
  • All eye conditions — the management of eye diseases at the office.