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Chalazion removal is a procedure aimed at addressing the discomfort and aesthetic concerns associated with the eyelid cysts known as chalazia. In this article, we review the comprehensive process of diagnosing, treating and recovering from chalazion removal.

What is a Chalazion?

A chalazion is a common eyelid condition characterized by a painless bump or swelling. Although there are similar eye conditions such as a stye (hordeolum) or blepharitis, chalazia are non-infectious cysts. A chalazion cyst can form on either your upper eyelid or lower eyelid, with the potential to grow in size and affect the field of vision.

What Causes Chalazions?

Chalazia result from the blockage of the meibomian glands, which are responsible for producing an oily substance known as “meibum” to lubricate the eyes. Blockage or obstruction of these oil glands can occur due to factors such as excess oil production, thickened secretions or inflammation. Underlying conditions such as rosacea, seborrheic dermatitis or hormonal changes can also predispose individuals to chalazion development.

The appearance of small, painless nodules on the eyelid, blurred vision, localized swelling and redness are all symptoms of a developing chalazion. Chalazia typically develop gradually over time and may initially resemble a stye before evolving into a painless, non-inflamed lesion. There are various risk factors associated with chalazion formation, as shown below:

  • Poor eyelid hygiene
  • Frequent use of eye makeup 
  • Contact lens usage
  • Pre-existing skin conditions

Due to the listed high-risk factors, it is important to seek prompt medical evaluation if symptoms worsen. Individuals with a history of meibomian gland dysfunction, immune system disorders or hormonal imbalances have an increased risk of negative experiences. If a chalazion goes untreated, it can lead to dangerous infections or vision impairment. 

Chalazion Diagnosis

Diagnosing chalazia involves multiple steps, beginning with a comprehensive eye examination conducted by a qualified healthcare professional. It is important to seek out an ophthalmologist or optometrist due to their expertise in reconstructive surgeries involving the eyelids. 

These healthcare experts perform visual inspections of the eyelid in a clinical setting to assess the size, location and characteristics of the lesion. Meibomian gland imaging or biopsies are diagnostic tests that can be utilized to help rule out other potential causes of eyelid nodules. 

Chalazion Non-Surgical Treatment Options

A common and simple way to manage mild or early-stage chalazia is by applying warm compresses to the affected eyelid multiple times a day and perform gentle eyelid massages to promote glandular drainage and reduce inflammation. There are options for over-the-counter remedies such as lubricating eye drops or ointments containing anti-inflammatory ingredients, oral antibiotics and topical antibiotic ointments. 

Antibiotic ointments are typically used in cases where a secondary bacterial infection is suspected or confirmed, making it imperative to complete the full course of action with the prescribed antibiotic.

Symptomatic relief may also be obtained through a simple eyelid hygiene practice, including regular cleansing with mild soap and water or avoiding the use of eye makeup until the chalazion resolves. In some cases, healthcare providers may opt for steroid injections to reduce the chalazion, as long as it’s non-infected. If noninvasive remedies are unsuccessful, or there is a recurrent chalazion, surgical removal of the chalazion is an alternative option. 

Chalazion Removal Surgery

Surgical removal of a chalazion is a suitable option if natural remedies are not soothing the discomfort, an infection has occurred or vision has been impaired. A surgical incision may also be necessary if the cyst has been persistent for more than two months. Surgery to treat a chalazion is an office procedure that takes approximately 20 minutes to perform and does not typically require stitches.

Preparing for the Procedure

Pre-operative preparations for chalazion removal involve scheduling the procedure at a convenient time and ensuring an adequate pre-operative assessment is performed by a qualified healthcare provider. Patients must abstain from eating or drinking for a specified period before the procedure, as instructed by their healthcare provider, to minimize the risk of complications associated with anesthesia administration. 

Disclosing relevant medical history, allergies or medications to the healthcare team will ensure safe and effective anesthesia management during the procedure. It is also important to avoid putting on any makeup or inserting contact lenses on the day of the chalazion surgery, as this could cause complications with the procedure. 

The Steps in Chalazion Removal Surgery

Local anesthesia is administered through the injection of a numbing agent into the surrounding tissue of the eyelid to ensure pain relief during the procedure, allowing the patient to remain awake and alert. 

Local anesthesia is efficient and safe for chalazion removal, even if the patient feels temporary discomfort or pressure during the injection process. The steps in chalazion surgical removal include the following: 

  • Sterilization of the eyelid and surrounding area using antiseptic solutions to minimize the risk of infection.
  • Use of a chalazion clamp to help stabilize the eyelid and provide a clear operative viewing field. 
  • Creation of an incision along the length of the eyelid, typically on the inner surface where the chalazion is located, using specialized surgical instruments to gently dissect the obstructed glandular tissue and remove the fluid.
  • Closure of the incision with absorbable sutures to approximate the edges of the incision and promote a quicker recovery

Recovery and Follow-Up

Post-operative care is as significant as pre-operative planning for ultimate health and recovery. Attending scheduled follow-up appointments with your healthcare provider after the surgical procedure is crucial to help monitor the progress of healing and assess for any signs of complications. 

Application of prescribed antibiotic ointment to the surgical site will help prevent infection. The use of cold compresses or ice packs applied intermittently to the eyelid will reduce swelling and alleviate discomfort in the immediate post-operative period, along with over-the-counter pain relievers such as acetaminophen or ibuprofen, as approved by your healthcare provider. Patients should also avoid rubbing the surgical site and wearing eye makeup or contact lenses until cleared by their healthcare provider. 

Although it is common to have initial post-operative discomfort, swelling and mild bruising around the surgical site, most patients can expect gradual improvement in symptoms over the course of several days to weeks. 

Final Thoughts

A chalazion is not necessarily a worrisome health concern unless it goes untreated and evolves into a major infection or impairs vision capabilities. To prevent this from occurring, practice proactive healthcare by scheduling regular eye examinations, addressing any abnormal meibomian gland inflammation and ensuring clean ocular hygiene. If you suspect a chalazion or have any concerns about your eye health, schedule an appointment with one of our ophthalmologists in Orlando at UCF Health today.