What are chalazae?

From the Guidelines

Chalazae are typically treated with warm compresses and gentle massage to promote drainage, and most resolve on their own within a few weeks, but if they persist, medical attention is necessary to rule out underlying conditions such as sebaceous carcinoma or ocular mucous membrane pemphigoid 1.

Treatment Options

• Apply warm compresses to the affected eyelid for 10-15 minutes, 4-6 times daily to help soften the hardened oil and promote drainage.
• Gently massage the area after applying the warm compress to help express the blocked material.
• Keep the eyelid clean and avoid eye makeup until the chalazion resolves.
• Over-the-counter pain relievers like ibuprofen can help with any discomfort.

When to Seek Medical Attention

• If the chalazion persists beyond 4-6 weeks.
• If it grows very large.
• If it affects vision.
• If it becomes increasingly painful or red.

Potential Underlying Conditions

• Sebaceous carcinoma: a malignant tumor that may induce severe conjunctival inflammation and can be difficult to diagnose 1.
• Ocular mucous membrane pemphigoid: a condition that can cause conjunctival cicatricial changes and requires a complete ocular surface exam and immunofluorescence studies of the biopsy specimen 1.

Diagnostic Considerations

• A biopsy of the eyelid may be indicated to exclude the possibility of carcinoma in cases of marked asymmetry, resistance to therapy, or unifocal recurrent chalazia that do not respond well to therapy 1.
• Consultation with a pathologist is recommended to discuss the potential need for frozen sections and mapping of the conjunctiva to search for pagetoid spread in cases of suspected sebaceous carcinoma 1.

From the Research

Definition and Causes of Chalazae

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

Treatment Options for Chalazae

• Treatment of choice differs among clinicians and may include:
  • Application of warm compress onto eyelids
  • Lid hygiene
  • Using local antibiotic ointment with or without steroids
  • Injecting steroid solution into the lesion
  • Surgical removal of the lesion by incision and curettage 2, 3.
• Other experimented methods include injection of botulinum toxin A, tarsal trephination, removal of chalazion by application of CO2 laser or cryogenic action 2.
• Topical treatment with antibiotics or steroids may be used, although its effectiveness is still being studied 4.

Effectiveness of Treatment Options

• Procedural management of chalazia, including corticosteroid injections and surgical management, is most often studied in the literature 5.
• Fewer publications exist on the efficacy of conservative and topical treatments 5.
• Topical treatment may not decrease the odds of undergoing procedural treatment, but may be beneficial for inflamed chalazia 4.

Note on Unrelated Studies

• Some studies, such as the one on Remdesivir for the treatment of Covid-19 6, are not relevant to the topic of chalazae.