From the Guidelines
The treatment for a chalazion typically begins with warm compresses applied to the affected eyelid for 10-15 minutes, 4-6 times daily, as this helps to soften the hardened oil and promote drainage. This approach is supported by general medical knowledge and is a common recommendation for managing chalazia [no direct evidence from 1 or 1, but based on general medical principles]. Gentle massage of the eyelid after applying warm compresses can further encourage drainage. Good eyelid hygiene is essential, including cleaning the eyelid margins with diluted baby shampoo or commercial eyelid cleansers.
For persistent chalazia, a doctor may prescribe antibiotic-steroid combination eye drops or ointments such as tobramycin/dexamethasone to be applied 2-4 times daily for 1-2 weeks. If these conservative measures fail after 4-6 weeks, or if the chalazion is large and causing vision problems, minor surgical drainage (incision and curettage) may be performed under local anesthesia. This procedure involves making a small incision on the inside of the eyelid and removing the contents of the chalazion. It's worth noting that while the provided evidence [e.g., 1] discusses blepharitis and its management, including the use of intense pulsed light (IPL) for meibomian gland dysfunction, the direct treatment of chalazia is not explicitly covered in these studies. However, the principles of managing related conditions can inform the approach to treating chalazia.
Key considerations in managing chalazia include:
- Warm compresses and gentle massage to promote drainage
- Good eyelid hygiene
- Potential use of antibiotic-steroid eye drops or ointments for persistent cases
- Surgical drainage for large or problematic chalazia
- Awareness of underlying conditions that may contribute to chalazia formation, such as blepharitis, rosacea, or seborrheic dermatitis, as mentioned in the context of blepharitis management 1.
From the Research
Treatment Options for Chalazion
- Intralesional corticosteroid injection: This method involves injecting a steroid, such as triamcinolone acetonide, directly into the chalazion lesion. Studies have shown that this treatment is effective, with success rates ranging from 77% to 88% 2, 3.
- Incision and curettage: This is a surgical procedure where the chalazion is removed through an incision. It is often used for cases where the chalazion is large or has become infected 3, 4.
- Warm compresses and lid hygiene: Applying warm compresses to the affected area and maintaining good lid hygiene may help to reduce the size of the chalazion and promote healing 4, 5.
- Antibiotic ointment: Using a local antibiotic ointment, with or without steroids, may help to prevent infection and promote healing 4, 5.
- Other treatments: Other treatments that have been experimented with include injection of botulinum toxin A, tarsal trephination, and removal of the chalazion using a CO2 laser or cryogenic action 4.
Factors Affecting Treatment Outcome
- Presence of infection: If the chalazion has become infected, surgery may be the preferred treatment option 2.
- Size and location of the chalazion: Larger chalazia or those located close to the lacrimal punctum may require more aggressive treatment 2, 6.
- Presence of underlying conditions: Certain underlying conditions, such as subclinical hypothyroidism, may predispose individuals to recurrent chalazia 5.
- Number of injections: Patients who require multiple injections of corticosteroid may be more likely to experience treatment failure or require surgical excision 6.