Chalazion
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A chalazion is a chronic inflammatory granuloma of a meibomian gland. It appears to be caused by alterations in secretions with retention of secretory material due to obstruction of the ducts. Chalazia originating in the Zeis sebaceous glands are termed “external chalazia”; those in the meibomian glands of the tarsus are termed “internal chalazia.”
Associated Conditions
- seborrhea
- chronic blepharitis
- acne rosacea.
Presentation
- soft tissue swelling
- erythema
- firm nodule
Course
- As the gland fills with oily secretions, it increases in size over weeks.
- The lesion most commonly is seen to bulge externally through the skin and less commonly through the conjunctiva.
- It could remain contained within the tarsus or break through anteriorly beneath the skin or on the conjunctival side, inducing pyogenic granuloma formation.
Treatment
- Medical treatment consists of warm compresses and topical antibiotic ointment.
- When the chalazion does not respond to more conservative medical management after 2 weeks, or when the lesion is large and symptomatic, surgical excision is indicated.
- Once excised, continued treatment with warm compresses is generally helpful. Antibiotic-steroid ointment is also helpful in the resolution of the chalazion.
Warnings
- It should be emphasized that any atypical or recurrent chalazion must be regarded as a possible neoplastic lesion and should be biopsied.
- Basal cell carcinoma, squamous cell carcinoma, and adenocarcinoma of the meibomian glands all have been mistaken for chalazia; these are Malignant ( Malignancy is the tendency of a cancer or tumor either to invade the surrounding tissues, to destroy or replace the tissues previously present or to metastasize (spread to other parts of the body) tumors.
