II. Epidemiology
- Occurs in all ages
III. Pathophysiology
- Meibomian Gland affected
- Sebaceous Gland in lid tarsal plate
- Chronic Granulomatous inflammation
IV. Symptoms
- Chronic, non-erythematous, non-fluctuant Nodule <1 cm
- Gradually developing (days to weeks), painless Eyelid Swelling
- Contrast with shorter durations (1-2 days) for Hordeolum development
V. Signs
- Small non-tender Nodule ("English pea")
- Deep cyst inside lid (not on margin)
- Adjacent to palpebral Conjunctiva
- Conjunctiva is red and elevated in affected area
VI. Differential Diagnosis
-
Internal Hordeolum (stye)
- Painful, inflamed, infected lid margin as contrasted with the painless, non-inflamed, sterile Chalazion
- Lid malignancy
- Biopsy needed if Chalazia recur in same area
VII. Management
- Small chronic Chalazia need no treatment
- Spontaneously resolve in weeks
- Larger chronic Chalazia
- Indications for treatment
- Cosmetic swelling
- Secondary Astigmatism from pressure on globe
- Refer to Ophthalmology for treatment
- Surgical Excision (preferred for larger lesions)
- Local Corticosteroid Injection
- Indications for treatment
- Infected Chalazia
- Same management as for Hordeolum