Derby Eye Surgery

What is it?

Often mistaken for the much rarer stye (infected eyelash follicle), chalazia are very common. They start off as discrete painless lumps in the upper or lower eyelid. They may enlarge and then become inflamed. In young children particularly, they can look quite alarming, especially if associated with a creamy discharge that can look like pus. Over a period of time, sometimes months, they resolve. After it looks like they have resolved the process can repeat itself and the lump returns.

What causes it?

There are about 20 wax glands (meibomian glands) within the cartilaginous plate of each eyelid. They secrete wax through ducts opening onto the eyelid margins. It is thought that somehow one of these ducts becomes blocked and as a result the gland swells up with the retained wax. This can occur to any number of glands on any lid. The resulting lump (chalazion) usually resolves over a period of weeks or months, presumably as the blockage is relieved.

Sometimes wax leaks out from the distended gland into the surrounding lid tissue. This sets off a “foreign body” reaction and the area becomes inflamed, occasionally dramatically so. In most cases this is “sterile” inflammation, that is, none infective. In severe cases the bloated gland can burst through the surface of the eyelid skin, discharging the wax, giving the appearance of pus from an abcess.

How is it treated?

Treatment depends on age of the patient and severity of the problem. Most chalazia will resolve without any treatment, given time. Because most (even the inflamed ones) are not caused by infection, antibiotics are of little use. They get better in spite of, not because of, the cream or drops. Even if there were an infective element (a micro abcess) cream or drops would not penetrate the skin to treat the abcess.

The best treatment, especially in the early non-inflamed stage, is simple cleaning of the eyelid margin with a cotton wool ball soaked in warm water. This is thought to melt any dried wax plugging the duct of the gland. It is not an overnight cure, but does speed up resolution of the problem. In small children this is virtually all that is ever needed. Recurrences are treated in the same way.

In older children and adults looking for a “quick fix”, one option is to drain the wax out of the distended gland by making a cut into it from the back of the eyelid (incision and curettage). The eyelid is numbed beforehand with an injection of local anaesthetic. This speeds up resolution of the chalazion though it still takes time. This quick fix is not really an option in young children because they would need putting to sleep. For a problem that will get better anyway, the risk of being put to sleep is not worth it.

Recurrences of chalazia are very common. If continual there may be an underlying inflammatory problem with the eyelid (blepharitis – see below).
Very small or resolving chalazia are best left to their own devices. If there is a predominantly inflammatory component and not much of a distended gland, injection of steroid into the inflamed area of the eyelid is a better option than incision.

Childrens eye problems

Lazy Eye
Refractive Errors
Sticky Eye


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 Roger Holden Eye Surgeon
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