Chalazion Treatment
The first-line treatment for chalazion includes daily eyelid hygiene with warm compresses and gentle massage to express the blocked meibomian glands. 1
Initial Conservative Management
- Apply warm compresses to the affected eyelid for 5-10 minutes, 3-4 times daily to help liquefy the thickened meibomian gland secretions 1, 2
- Perform gentle massage of the eyelids after applying warm compresses to help express the blocked glands 1
- Maintain good eyelid hygiene to prevent recurrence and treat underlying blepharitis or meibomian gland dysfunction 3
- Conservative treatment should be tried for approximately 4 weeks before considering more invasive options 1, 2
Medical Treatment Options
- Topical corticosteroid ointments may be applied to reduce inflammation if the condition persists despite warm compresses 1
- For persistent chalazia, intralesional steroid injection (triamcinolone acetonide) can be effective, with studies showing resolution rates of up to 89.6% 4, 5
- Be aware that steroid injections may cause local skin depigmentation in some patients 4
Surgical Management
- Incision and curettage is indicated for chalazia that persist despite 4 weeks of conservative treatment 1, 5
- The procedure involves making a small incision (usually through the conjunctival side of the eyelid) and removing the contents of the chalazion 5, 6
- Thermal cautery after surgical incision and drainage is optional, as research shows it does not significantly affect recurrence rates 6
Advanced Treatment Options
- Intense pulsed light (IPL) with meibomian gland expression has shown promise for recurrent multiple chalazia 7
- Other experimental methods include botulinum toxin A injection, tarsal trephination, CO2 laser application, or cryotherapy, though these are not standard first-line treatments 8
Warning Signs Requiring Further Evaluation
- Recurrent chalazia in the same location should raise suspicion for sebaceous carcinoma, especially in elderly patients 7, 3, 1
- Biopsy should be considered for:
Follow-up Recommendations
- Patients should return for follow-up if symptoms worsen 7
- For patients treated with corticosteroids, re-evaluation within a few weeks is recommended to assess response and check intraocular pressure 7
- Children with chalazia may have underlying chronic blepharokeratoconjunctivitis that requires evaluation by an ophthalmologist, especially if there is visual loss, moderate/severe pain, or severe/chronic redness 7, 3