A chalazion is a small mass that develops on or in the interior layers of the eyelid, which is usually painless and diminishes within a few days or weeks. Since a single chalazion or many chalazia arise solely on the eyelids owing to inflammation from blocked meibomian glands, the condition is also referred to as meibomian cyst or eyelid cyst. Due to its outward appearance of a prominent red lump on the eyelid, a chalazion is often mistaken for a stye. However, the two eye-related disorders are different, in that while a chalazion happens due to blocked meibomian glands and is pain-free, styes arise from infections present in either oil glands or within the eyelash hair follicles and are very painful.
The meibomian gland is a type of sebaceous gland located in the tarsal plates – the structural components of eyelids composed of dense connective tissue that also house the eyelash follicles. In normal, healthy individuals, the meibomian gland secretes meibum – an oily substance that delivers ample lubrication to the surface of the eye and prevents the instance of dry eyes.
However, in people with underlying inflammatory maladies, the meibomian gland is obstructed, thereby getting clogged with oil secretions and swelling up, forming a hard lump on the eyelid called a chalazion.
While small chalazia generally disappear after a few days or 1 – 2 weeks, the larger lumps on the eyelids tend to create intense pressure on the cornea, causing major discomfort in seeing things clearly. As this could even result in astigmatism – wherein the shape of the eye is distorted hampering eyesight, chalazia hence must be reported to a doctor promptly for timely treatment and restoring visual functions in the patient.
Causes Of A Chalazion Or Eyelid Cyst:
The primary reason why chalazia develop on the eyelids is the blockage of meibomian glands. This can happen due to various pre-existing inflammatory disorders such as:
- Chronic blepharitis – which is a condition of inflammation and infection in the eyelids
- Rosacea – an inflammatory skin ailment characterised by redness and acne
- Seborrheic dermatitis – a chronic inflammation in the dermal tissues of the skin leading to redness, dryness, itching and flaking
- Viral infections in the eye like conjunctivitis owing to a viral pathogen
- Ocular TB - Tuberculosis of the eye i.e. bacterial infections in the visual organs inducing eyelid abscesses
Chalazia tend to emerge predominantly in adults between the ages of 30 – 50 years, but at times can also affect children. Furthermore, a previous incidence of a stye or chalazion poses a higher risk of acquiring a chalazion again later on.
The distinguishing signs of chalazia comprise:
- Painless lumps on the eyelids, mostly forming on the upper eyelids
- Minor irritation near the eyelashes, prompting itching and watery eyes
- Blurred hazy vision due to big-sized eyelid cysts that impede eyeball and eyelid movement and decrease visual clarity
The eye specialists i.e. optometrists and ophthalmologists perform an external eye exam, mainly examining the external segments of the eyes, eyelids, eyelashes and texture of the skin in surrounding vicinities to look for signs of inflammation. Furthermore, a special apparatus of a bright light with a magnifying lens is placed directly above the eyelids and eyelashes, to clearly view the in-depth portions of the base of the eyelashes and probe the openings to the oil-producing gland i.e. meibomian gland, to see if any obstructions and lumps are present.
The healthcare provider also records the complete medical history of the patient, to identify if any underlying inflammatory disorders such as blepharitis or rosacea could be the chief factor inducing chalazia in the eyelids.
In the majority of instances, chalazia that form on the upper eyelids are small and become smaller and gradually diminish on their own in a few days, weeks or a month at the maximum, without any specific treatment. Nevertheless, the medical practitioner advises the patient to avoid pushing or squeezing the chalazia, as it is present directly on the eyelids and applying immense force can cause damage or injury to the eyes which are delicate, sensitive sensory organs.
The doctor advises the patient to apply warm compresses, medicated eye pads, eye ointments and gentle massages on the eyelids, to lessen swelling in the eyelids and open up the blocked meibomian gland ducts. Proper personal hygiene practices of steering clear of donning eye makeup, greasy products on the eyelids, washing the eyes thoroughly and not touching the eyes often helps in minimising the chalazia or eyelid cysts.
However, in certain cases, the chalazia that arise on the eyelids are significantly bigger in size and can hamper eyesight. The physician then performs a surgery to drain the accumulated fluid/oil in the meibomian glands by means of a small incision or administers steroid injections to lower inflammation in the eyelids and restore optimal visual functions in the patient.