Chalazion


Chalazion

Description, Causes and Risk Factors:

A chronic inflammatory granuloma of a meibomian gland.

A chalazion is a lump of the lid that is caused by obstruction of the drainage duct of an oil gland within the upper or lower eyelid. This lump may increase in size over days to weeks and may occasionally become red, warm, or painful.

The gland involved in the formation of a chalazion is a modified oil gland (meibomian gland) that lies within the eyelid. There are about 30-40 of these glands within each of the upper and lower lids. These glands secrete oil into the tears. When one of these glands becomes blocked, it can increase in size and cause a visible lump.

Chalazion

Although a sty is also a lump in the eyelid caused by obstruction of an oil gland, a chalazion is not a sty. A sty, or hordeolum, represents an acute infection of the gland. A chalazion is not an infection but is an inflammation of the area. Inflammation is a process in which the body reacts to a condition and produces swelling, redness, pain, or warmth. A sty is usually more painful than a chalazion and may appear infected.

Each of the oil glands, called Meibomian glands, produces oil which flows out of the gland into the tears. The oil exits from each gland through a tiny circular opening just behind the eyelashes of the upper and lower lids. A chalazion is caused by the oil in the gland becoming too thick to flow out of the gland or the opening of the gland being obstructed. Without anywhere to go, the oil builds up inside the gland and forms a lump in the eyelid. The gland wall may break, releasing the oil into the tissue of the eyelid, causing inflammation and sometimes scar tissue.

Some individuals have thicker Meibomian gland secretions than others and, therefore, have a greater risk of developing a chalazion. If you have had one chalazion, you are at greater risk of developing another one in the future. People with acne rosacea, because of alterations within the oil glands of the face, are at greater risk of developing chalazions.

The exact incidence or prevalence is unknown. Male and females seem equally affected.

Symptoms:

    Eyelid redness.

  • Swelling on the eyelid.

  • Eyelid tenderness.

  • Sensitivity to light.

  • Increased tearing.

  • Heaviness of the eyelid.

Diagnosis:

Clinical findings and responses to therapy in patients with chalazion are usually specific.The material obtained from a chalazion shows a mixture of acute and chronic inflammatory cells, as well as large, lipid-filled, foreign body-type giant cells.

Lipid analysis may reveal fatty acids with long carbon chains resulting in an increased melting point. This finding possibly accounts for the blockage of secretions.

Bacterial culture findings are usually negative. However, Staphylococcus aureus, Staphylococcus albus, or other cutaneous commensal organisms can be isolated. Propionibacterium acnes may be present in the glandular contents.

Infrared photographic imaging of the meibomian glands can demonstrate abnormally dilated and inspissated secretions, which are visible on the tarsal surface of the everted lid.

Treatment:

The regular use of warm compresses applied to the closed eyelids for five minutes before bedtime can be helpful in preventing the Meibomian glands from clogging during the night. In people with seborrhea of the lids and recurrent chalazions, warm compresses and careful cleansing of the lid margins can be helpful for prevention. Some patients with recurrent chalazions can benefit by chronic use of oral low-dose tetracycline, which changes the metabolism of the oil-producing glands.

Topical antibiotic eye drops or ointment are sometimes used for the initial acute infection, but are otherwise of little value in treating a chalazion. Chalazion will often disappear without further treatment within a few months and virtually all will re-absorb within two years.

If they continue to enlarge or fail to settle within a few months, then smaller lesions may be injected with a corticosteroid or larger ones may be surgically removed using local anesthesia. This is usually done from underneath the eyelid to avoid a scar on the skin. If the chalazion is located directly under the eyelid's outer tissue, however, an excision from above may be more advisable so as not to inflict any unnecessary damage on the lid itself.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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