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Chalazion

  • A chalazion is a chronic inflammatory granuloma of a meibomian gland. It appears to be caused by alterations in secretions with retention of secretory material due to obstruction of the ducts.
  • Chalazia originating in the Zeis sebaceous glands are termed "external chalazia"; those in the meibomian glands of the tarsus are termed "internal chalazia."

Associated Conditions

  • seborrhea
  • chronic blepharitis
  • acne rosacea.

Presentation

  • soft tissue swelling
  • erythema
  • firm nodule

 



Course

  • As the gland fills with oily secretions, it increases in size over weeks.
  • The lesion most commonly is seen to bulge externally through the skin and less commonly through the conjunctiva.
  • It might remain contained within the tarsus or break through anteriorly beneath the skin or on the conjunctival side, inducing pyogenic granuloma formation.

Treatment

  • medical treatment consists of warm compresses and topical antibiotic ointment.
  • When the chalazion does not respond to more conservative medical management after 2 weeks, or when the lesion is large and symptomatic, surgical excision is indicated.
  • Chalazion surgery procedure

  • Once excised, continued treatement with warm compresses is generally helpful
  • Once excised, treatment with an antibiotic-steroid ointment such as
     
    also helps resolution of the chalazion

Warnings

  • It should be emphasized that any atypical or recurrent chalazion must be regarded as a possible neoplastic lesion and should be biopsied.
  • Basal cell carcinoma, squamous cell carcinoma, and adenocarcinoma of the meibomian glands all have been mistaken for chalazia; these are Malignant ( Malignancy is the tendency of a cancer or tumor either to invade the surrounding tissues, to destroy or replace the tissues previously present or to metastasize (spread to other parts of the body) tumors.