Chalazion

Aka: Chalazion, Chalazia

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II. Epidemiology

  1. Occurs in all ages

III. Pathophysiology

  1. Meibomian Gland affected
    1. Sebaceous Gland in lid tarsal plate
  2. Chronic Granulomatous inflammation

IV. Symptoms

  1. Chronic, non-erythematous, non-fluctuant Nodule <1 cm
  2. Gradually developing (days to weeks), painless Eyelid Swelling
    1. Contrast with shorter durations (1-2 days) for Hordeolum development

V. Signs

  1. Small non-tender Nodule ("English pea")
  2. Deep cyst inside lid (not on margin)
  3. Adjacent to palpebral Conjunctiva
    1. Conjunctiva is red and elevated in affected area

VI. Differential Diagnosis

  1. Internal Hordeolum (stye)
    1. Painful, inflamed, infected lid margin as contrasted with the painless, non-inflamed, sterile Chalazion
  2. Lid malignancy
    1. Biopsy needed if Chalazia recur in same area

VII. Management

  1. Small chronic Chalazia need no treatment
    1. Spontaneously resolve in weeks
  2. Larger chronic Chalazia
    1. Indications for treatment
      1. Cosmetic swelling
      2. Secondary Astigmatism from pressure on globe
    2. Refer to Ophthalmology for treatment
      1. Surgical Excision (preferred for larger lesions)
      2. Local Corticosteroid Injection
  3. Infected Chalazia
    1. Same management as for Hordeolum

VIII. References

  1. Carlisle (2015) Am Fam Physician 92(2): 106-12 [PubMed]
  2. O'Malley (2024) Am Fam Physician 109(2): 179-80 [PubMed]

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