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A bump on the eyelid that pops out of nowhere can be concerning. Sometimes these growths, which might be a stye or a chalazion, can go away on their own, but other times they require medical attention. Focus spoke with Prashant Yadav, MD, director of the Chalazion Clinic at Mass Eye and Ear, to learn more about what causes these growths, how they can prevented and treated, and when to seek help.
What exactly is a chalazion?
We have numerous oil glands in our eyelids that produce secretions that lubricate the eye’s surface, which allows tears to spread over the eyeball. These glands, called meibomian glands, can get blocked by inflammation, dust or other factors. This causes pus to build up in the gland and eyelid and a little bump to form. When the bump becomes chronic and does not go away, it becomes a chalazion. Sometimes these can heal on their own with local management or ointments, but other times they persist and need to be drained by a physician.
How is a chalazion different from a stye?
A stye is an acute infection of the gland that is usually red, swollen and painful. Once the infection resolves, it might leave behind a chronic inflammation of the gland, which is a chalazion. People with chalazions may experience chronic inflammation of the eyelid which increases and decreases in size during the course of weeks or months, and some redness. Typically, a chalazion is not painful. If it is large enough, it can cause burry vision.
How is a chalazion treated?
There are a lot of ways to treat both styes and chalazions at home, including warm compresses, eyelid scrubs or some over-the-counter antibiotic eye ointments. If the pore opens of the blocked gland, the pus will come out. But if it does not open, the pus doesn’t come out, and in these cases, people might need to see an eye doctor to get chalazion drained.
What is the procedure to drain a chalazion?
During the procedure, the patient is marked up first to show which eyelid has to be drained. The patient then lays down, and some lidocaine is injected to numb the eyelid. Once the patient is numb, a clamp is used that that flips the eyelid open. Then we make an incision with a sharp blade and scoop all the pus out. Afterwards, the patient has to wear a bandage for the next few hours. Following the procedure, the patient is given an antibiotic eye ointment to use twice a day for seven days. In some cases, if the patient has a bad inflammatory condition of the eyelid, we will prescribe oral antibiotics afterwards. Normally there is no follow-up needed; if we do 100 cases at our clinic, only about five patients will come back with a recurrence of their chalazion.
Once you have a chalazion drain, you might get one in another area at a later time. Some patients just have a propensity to get chalazions recurrently, there’s no way to know when and how.
Where can I get a chalazion drained?
It can be difficult to get an appointment quickly to get a chalazion drained. Not all ophthalmologists do the procedure, and some oculoplastic surgeons who do have busy case loads of urgent medical issues like cancers or eyelid reconstructions, which increases the time it takes to get an appointment. To enable patients to be seen faster at Mass Eye and Ear, we launched a Chalazion Clinic in 2019, one of the only clinics of its kind on the east coast and in the country.
Tell me more about Mass Eye and Ear’s Chalazion Clinic
This is a very unique service we offer at Mass Eye and Ear, in which two days a week we run a clinic that is staffed by residents, under the oversight of an oculoplastic surgeon (myself), for the sole purpose of draining a chalazion. A patient can call our main ophthalmology phone number (617-573-3202) and ask to get referred to the Chalazion Clinic. We will typically see about eight patients per day, twice a week.
Are certain people at risk for a chalazion?
Individuals who work long hours on computer screens are at particular risk for chalazions. The long hours on the screen cause a continuous cycle of inadequate blinking, ocular surface dryness and eyelid inflammation. Professionals who are involved in outdoor work (exposed to the environment) are also at risk.
Recently, COVID and mask use has led to an uptick in chalazions. There is a recent publication linking this association.
COVID-19 itself does not cause a chalazion. However, it’s been reported that wearing masks is correlated to an increase in chalazion. The postulated theory is that oral breath is causing chronic eyelid inflammation and blocking meibomian glands. Specifically, when we breathe while wearing a mask, the oral breath is drying the eyelid and chronically inflaming them, leading to a chalazion.
Between mask wearing and increases in screen time caused by remote work, doctors are seeing a chalazion epidemic amid the pandemic. Recently, we presented on the uptick in the number of patients we’ve seen at our Chalazion Clinic at the 2022 ARVO Annual Meeting.
Can a chalazion be prevented?
The best way to prevent a chalazion is to take regular breaks in screen time. I recommend people take a 5-minute break after 30 minutes. Maintaining good hand and face hygiene is also important for prevention.
To make an appointment with the Chalazion Clinic at Mass Eye and Ear, contact 617-573-3202.
About our expert
Prashant Yadav, MD, is Medical Director of the Ophthalmology Consult Service. He is fellowship trained in ophthalmic plastic and reconstructive surgery and specializes in orbital surgery, lacrimal surgery and ocular oncology, as well as ocular trauma. Dr. Yadav sees patients at the Mass Eye and Ear main campus.