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

Symptoms

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 http://www.lucille-solomon.com

causes

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.

diagnosis

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 (!)

treatment

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

literature
  • Arbabi E.M., Kelly R.J., Carrim Z.I. Chalazion. BMJ, 2010, 341, c4044 Pubmed
  • Ben Simon G.J., Huang L., Nakra T., Schwarcz R.M., McCann J.D., Goldberg R.A. Intralesional triamcinolone acetonide injection for primary and recurrent chalazia: is it really effective? Ophthalmology, 2005, 112 (5), 913-7 Pubmed
  • Bernardes T.F., Bonfioli A.A. Blepharitis. Semin Ophthalmol, 2010, 25 (3), 79-83 Pubmed
  • Carter S.R. Eyelid disorders: diagnosis and management. Am Fam Physician, 1998, 57 (11), 2695-702 Pubmed
  • Chung C.F., Lai J.S., Li P.S. Subcutaneous extralesional triamcinolone acetonide injection versus conservative management in the treatment of chalazion. Hong Kong Med J, 2006, 12 (4), 278-81 Pubmed
  • Dhaliwal U., Bhatia A. A rationale for therapeutic decision-making in chalazia. Orbit, 2005, 24 (4), 227-30 Pubmed
  • Gilchrist H., Lee G. Management of chalazia in general practice. Aust Fam Physician, 2009, 38 (5), 311-4 Pubmed
  • Goawalla A., Lee V. A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses. Clin Experiment Ophthalmol, 2007, 35 (8), 706-12 Pubmed
  • Grehn F. Ophthalmology. Heidelberg: Springer, 2006
  • Lederman C, Miller M. Hordeola and chalazia. Pediatr Rev, 1999, 20 (8), 283-4 Pubmed
  • Ophthalmology textbooks
  • Ozdal P.C., Codère F., Callejo S., Caissie A.L., Burnier M.N. Accuracy of the clinical diagnosis of chalazion. Eye (Lond), 2004, 18 (2), 135-8 Pubmed
  • Sharma S. Ophthalmic Problem. Chalazion. Can Fam Physician, 1998, 44, 1249 Pubmed
  • Sorbara L., Maram J., Bizheva K., Hutchings N., Simpson T.L. Case report: Chalazion and its features visualized by ultrahigh resolution optical coherence tomography. Cont Lens Anterior Eye, 2010 Pubmed
  • Unal M. Chalazion treatment. Orbit, 2008, 27 (6), 397-8 Pubmed
Authors

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 http://www.lucille-solomon.com


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