03/28/2017
Chalazia (or colloquially referred to as "styes") are one of the commonest complaints of patients I see in the office on an urgent basis.
These lumps can appear on the inside or the outside of the eyelid from a meibomian gland (oil producing structures) that has become congested, blocked, or inflamed. Contrary to popular belief, they are not eye infections. When chalazia get large, they can also cause adjacent tissue inflammation, swelling, and discomfort. If large enough, they can even push on the cornea and cause astigmatism or obstruction of vision. In young kids, amblyopia (lazy eye) can develop if not treated expediently.
Patients frequently come in to my office and want to know what their options are. If it is early on, I highly recommend hot compresses either with a washcloth, tea bags, or a dry heat pack applied for 5-10 minutes once or twice a day for 2-3 weeks. Occasionally, doctors will prescribe an eye ointment to help reduce the bacterial load, but I often find these to not be of great help.
If the chalazion persists for more than 2-3 weeks and does not go away with regular hot compresses and/or ointment, then coming to see me may help. Depending on the appearance and chronicity, I may suggest either injecting it with Kenalog (a highly concentrated steroid medication) or doing an incision and curettage procedure in the office. The latter surgical procedure can be done internally or externally, depending on the location of the gland that has become inflamed. Typically, this procedure leaves no scar behind if done carefully. Steroid injections are generally safe and effective, but has a small risk of causing hypopigmentation of the eyelid.
Unfortunately, these annoying and unsightly meibomian maladies can recur, but with good eyelid hygiene, education, and regular visits with your ophthalmologist, you can help lower the chances that they come back.