What is the cause of a chalazion and how should it be treated?

From the Guidelines

A chalazion is caused by a blockage of an oil gland (meibomian gland) in the eyelid, which leads to inflammation and swelling, and the most effective treatment is warm compresses applied to the affected eyelid for 10-15 minutes, 4-6 times daily, as recommended by the most recent study 1. The treatment of a chalazion should prioritize reducing inflammation and promoting drainage of the blocked oil gland.

• Warm compresses are the first line of treatment, as they help soften the hardened oil and promote drainage.
• Gentle massage of the eyelid after applying the warm compress can help express the blocked material.
• For persistent chalazia, antibiotic-steroid combination eye drops or ointments may be prescribed, such as tobramycin/dexamethasone applied 2-4 times daily for 7-10 days, as suggested by 1.
• If the chalazion doesn't respond to these conservative measures within 2-4 weeks, or if it's particularly large or causing vision problems, surgical incision and drainage by an ophthalmologist may be necessary, as indicated by 1 and 1. The inflammation occurs because the trapped oil triggers an immune response in the surrounding tissue, creating the characteristic painless bump.
• Good eyelid hygiene, including regular cleansing with baby shampoo or commercial eyelid cleansers, can help prevent recurrence by keeping the oil glands flowing properly. It's also important to note that an eyelid tumor should be suspected in patients with atypical eyelid-margin inflammation or disease not responsive to medical therapy, and these patients should be carefully re-evaluated, as recommended by 1 and 1.
• The presence of features such as nodular mass, ulceration, extensive scarring, lash loss, localized crusting and scaling of the dermis, or yellow conjunctival nodules surrounded by intense inflammation may suggest the presence of an eyelid tumor.
• Sebaceous carcinoma should be considered in elderly patients who have unresponsive, chronic, unilateral blepharitis or conjunctivitis, or recurrent chalazia, as suggested by 1 and 1.

From the Research

Cause of Chalazion

• A chalazion is a non-inflammatory process that develops due to retained secretion of the meibomian or Zeis glands 2
• It is seen in all age groups and is one of the most common eye conditions presenting as a mass lesion of the eyelids 2

Treatment of Chalazion

• Treatment options include:
  • Application of warm compress onto eyelids
  • Lid hygiene
  • Using local antibiotic ointment with or without steroids
  • Injecting steroid solution (triamcinolone acetonide) into the lesion
  • Surgical removal of the lesion by incision and curettage 2, 3, 4
• Intralesional steroid injection is an effective, easy, and safe method, with perfect recovery achieved in 88% of cases 5
• Conservative treatment with lid hygiene can be approximately 80% effective in treating chalazia 6
• A single triamcinolone acetonide injection followed by lid massage is almost as effective as incision and curettage in the treatment of chalazia, with similar patient satisfaction and less pain and patient inconvenience 4