Chalazion

Background

Anterior view of the right eye, with lacramal duct shown medial.

The tarsi and their ligaments. Right eye; anterior view.

• Chronic inflammatory lesion due to blockage of Zeis or meibomian tear gland
• Also known as meibomian gland lipogranuloma
• Often results from healing hordeolum

Clinical Features

Chalazion of right eye

• Eyelid swelling and erythema that evolve into a painless, rubbery, nodular lesion
• More commonly seen on upper eyelid where density of Meibomian glands is greatest

Differential Diagnosis

Periorbital swelling

Proptosis

• Normal IOP
  • Orbital cellulitis
  • Orbital pseudotumor
  • Orbital tumor
• Increased IOP
  • Retrobulbar abscess
  • Retrobulbar emphysema
  • Retrobulbar hemorrhage
  • Ocular compartment syndrome
  • Orbital tumor

No proptosis

• Periorbital cellulitis/erysipelas
• Dacryocystitis (lacrimal duct)
• Dacryocele/Dacryocystocele
• Dacryostenosis
• Dacryoadenitis (lacrimal gland)
• Allergic reaction
• Nephrotic Syndrome (pediatrics)

Lid Complications

• Blepharitis (crusts)
• Chalazion (meibomian gland)
• Stye (hordeolum) (eyelash folicle)

Other

• Subperiosteal abscess
• Orbital abscess
• Cavernous sinus thrombosis
• Conjunctivitis
• Contact dermatitis
• Herpes zoster
• Herpes simplex
• Sarcoidosis
• Granulomatosis with polyangiitis

Management

• Discontinue eye makeup and contacts until resolved
• Hot compresses x15min QID
• Antibiotics not indicated: this is a granulomatous condition
• Most resolve without intervention in weeks-months

Disposition

• Refer to ophthalmology if persistent or recurring

See Also

• Hordeolum