From the Guidelines
Chalazion treatment typically begins with warm compresses applied to the affected eyelid for 10-15 minutes, 4-6 times daily, as this helps soften the blocked oil and promote drainage, and is recommended based on general medical knowledge and expert opinion 1.
Key Points to Consider
- Gentle eyelid massage after warm compresses can further encourage drainage.
- Keeping the eyelid clean using mild, diluted baby shampoo on a clean washcloth is also important.
- 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.
- Oral antibiotics like doxycycline (100mg twice daily) might be prescribed if there's significant inflammation or infection.
- If the chalazion doesn't respond to these conservative treatments within 2-4 weeks or is particularly large and bothersome, minor surgical drainage (incision and curettage) may be necessary under local anesthesia.
Rationale for Treatment Approach
The approach to treating chalazia focuses on reducing inflammation and restoring normal gland function, as chalazia form when oil glands in the eyelid become blocked and inflamed, creating a small, painless bump 1.
Considerations for Specific Patient Groups
- Elderly patients or those with a history of multiple chalazion excisions should be evaluated for potential underlying conditions such as sebaceous carcinoma, which may present similarly to a chalazion but requires different management 1.
- Patients with significant inflammation or infection may require oral antibiotics, and those who do not respond to conservative treatments may need minor surgical drainage 1.
From the Research
Treatment Options for Chalazion
- Intralesional triamcinolone acetonide injection: This treatment option has been shown to be effective in achieving lesion regression, with most cases resolving with an average of 1 to 2 injections 2, 3, 4, 5.
- Incision and curettage: This is a conventional treatment option for chalazia, and has been compared to intralesional triamcinolone acetonide injection in several studies, with similar success rates 3, 4, 5.
- Hot compresses: This is a conservative treatment option that has been shown to be less effective than intralesional triamcinolone acetonide injection and incision and curettage 5.
- Thermal cautery: This has been studied as an additional treatment after chalazion surgery, but has been found to have no significant impact on recurrence rates 6.
Factors Affecting Treatment Outcome
- Size of the chalazion: Larger chalazia may require more injections or alternative treatment options 4.
- Presence of blepharitis: Patients with blepharitis may require more injections to achieve resolution 2.
- Location of the chalazion: Chalazia near the lacrimal drainage system may be more suitable for intralesional triamcinolone acetonide injection 3.
Complications and Side Effects
- Intralesional triamcinolone acetonide injection: No significant complications have been reported, including visual loss, subcutaneous fat atrophy, or skin depigmentation changes 2, 3, 5.
- Incision and curettage: May cause more pain and inconvenience compared to intralesional triamcinolone acetonide injection 5.