How are chalacias treated

Hailstone (chalazion)A hailstone is painless swelling in the eyelid caused by obstruction of a meibomian gland and localized lipogranulomatous inflammation. The slowly developing lump is benign and can recede on its own over time. The application of warm compresses, good eyelid hygiene and regular massage are recommended for treatment. Secondary, a minor intervention or a local corticoid injection is possible.

synonymous: chalazion, chalazia, meibomian cyst


A hailstone (Greek chalazion, χαλαζιον) is a painless, pea-sized lipogranulomatous swelling of a meibomian gland in the eyelid. The knot is just below or above the edge of the eyelid and enlarges over several weeks (image, click to enlarge). It can cause eye irritation, an unpleasant foreign body sensation and dry eyes. Larger lumps cause visual disturbances such as blurred vision and drooping of the eyelids. Chalazia are cosmetically disruptive.

© Lucille Solomon, 2011


The cause of the disease is an occlusion of the duct of the meibomian gland. The oily secretions are retained and lead to an inflammatory reaction and the formation of a lump. Risk factors for developing hailstones include eyelid inflammation, which is often caused by seborrhea, rosacea, or an infection.


The diagnosis is made under medical treatment. A sore and red lump on the edge of the eyelid indicates a stye, swollen, inflamed, reddened and crusted eyelids indicate an inflammation of the eyelid. Other possible differential diagnoses include sebum carcinoma and dacryocystitis. When making a diagnosis, it is important to note that similar symptoms can also be caused by malignant neoplasms (!)


A hailstone can resolve itself over the course of weeks or months. However, the course is often chronically recurring. Daily eyelid hygiene and care is seen as the first choice:

  • Apply compresses at body temperature for about 3-10 minutes in the morning and in the evening in order to liquefy the material in the knot. For example, a washcloth moistened with warm water can be used.
  • Regular massage of the hailstone with the clean fingertip towards the eyelid.
  • In the case of a simultaneous inflammation of the lind margin, good eyelid margin hygiene is recommended, e.g. with a damp cloth (see there).

Less than half of all patients can be freed from hailstones with conservative treatment. As a second choice, a minor procedure (incision and curettage) or a local corticoid injection with triamcinolone acetonide are available. Antibiotics are only used for accompanying infections. Underlying diseases such as rosacea are treated separately.

see also

Barley grain, millet grain (milia), eyelid inflammation

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Conflicts of Interest: None / Independent. The author has no relationships with the manufacturers and is not involved in the sale of the products mentioned.

Image: Lucille Solomon

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