Chalazion

A chalazion is a slowly developing, usually painless bump on the eyelid caused by a blocked meibomian (oil) gland. Unlike a stye (hordeolum), which is an acute infection, a chalazion is a chronic inflammatory response to trapped oil. While often resolving with home treatment, some chalazia require minor surgical drainage.

Chalazion vs. Stye

Feature	Chalazion	Stye
Cause	Blocked gland (chronic)	Infected gland (acute)
Pain	Usually painless	Painful, tender
Location	Usually mid-lid, points inward	Lid margin, points outward
Onset	Gradual (days to weeks)	Rapid (1-2 days)
Treatment	Warm compresses, possibly surgery	Warm compresses, antibiotics if needed

Note: A stye can evolve into a chalazion once the acute infection resolves but the blocked material remains.

Symptoms

What It Looks and Feels Like

• Firm, round bump on eyelid
• Usually painless (may be tender initially)
• Gradually enlarges over days to weeks
• Can occur on upper or lower lid
• May point toward the inside of the lid
• Can cause lid swelling
• Vision may be affected if large (presses on eye)

When It Becomes a Problem

• Cosmetically noticeable
• Large enough to press on eyeball (causing blurred vision or astigmatism)
• Persistent despite treatment
• Recurrent chalazia

Causes and Risk Factors

How It Develops

1. Meibomian gland becomes blocked
2. Oil backs up in the gland
3. Gland ruptures internally
4. Body mounts inflammatory response to leaked oil
5. Inflammatory tissue (granuloma) forms—the chalazion

Risk Factors

• Meibomian gland dysfunction (MGD)
• Blepharitis
• Rosacea
• Seborrheic dermatitis
• Previous chalazia
• Poor lid hygiene
• Contact lens wear
• High-fat diet (possibly)

Treatment

Home Treatment (First Line)

Lid Hygiene

• Lid scrubs to keep lid margins clean
• Treat underlying blepharitis
• Hypochlorous acid spray

Medical Treatment

If not improving with warm compresses:

Steroid Injection

• Corticosteroid injected into chalazion
• Reduces inflammation
• Can resolve chalazion without surgery
• May need multiple injections

For Recurrent Chalazia

• Oral doxycycline (50-100 mg daily for 3+ months)
• Anti-inflammatory effect on meibomian glands
• Reduces recurrence rate

Surgical Treatment

Incision and Curettage (I&C)

When warm compresses and/or injection don't work:

• Minor in-office procedure
• Local anesthesia
• Incision usually on inside of lid (no visible scar)
• Contents scraped out
• Heals quickly
• May use antibiotic ointment after

When to See a Doctor

Routine Evaluation

• Chalazion not improving after 4-6 weeks of warm compresses
• Chalazion larger than a pea
• Affecting vision
• Recurrent chalazia

Urgent Evaluation

Complications

From the Chalazion

• Cosmetic concern
• Induced astigmatism (from pressure on eye)
• Secondary infection (becoming a stye)
• Granuloma formation
• Rarely: preseptal cellulitis if infected

From Surgery (Uncommon)

• Bleeding
• Infection
• Recurrence
• Lid notching (rare)

Prevention

If You're Prone to Chalazia

• Daily warm compresses
• Regular lid hygiene
• Treat blepharitis and MGD
• Consider omega-3 supplements
• Avoid touching/rubbing eyes

When to Consider LipiFlow or Similar

For patients with frequent recurrent chalazia due to MGD, in-office treatments like thermal pulsation (LipiFlow) may help prevent future episodes.

Chalazion in Children

Chalazia are common in children:

• Treatment approach similar to adults
• Warm compresses can be challenging (shorter attention span)
• Surgery may require general anesthesia in young children
• Most resolve with conservative treatment
• Rule out other conditions if atypical

Frequently Asked Questions

How long will it take to go away?

With consistent warm compress treatment, many chalazia resolve in 2-8 weeks. Some may take longer or require additional treatment. Patience and consistency are key.

Can I pop or squeeze it?

No. Attempting to squeeze a chalazion can worsen inflammation, spread material into surrounding tissue, or introduce infection. Let it resolve naturally or seek medical treatment.

Will it come back?

Recurrence is possible, especially if you have underlying MGD or blepharitis. Maintaining good lid hygiene and treating underlying conditions reduces recurrence risk.

Is a chalazion contagious?

No. Chalazia are not infections and cannot spread to other people. Unlike conjunctivitis, you don't need to worry about contaminating others.

Will it leave a scar?

If treated conservatively (warm compresses) or with standard surgical technique (incision on inside of lid), scarring is minimal or invisible. External incisions are sometimes needed for very large chalazia and may leave a small scar.

Can a chalazion be cancerous?

Typical chalazia are not cancerous. However, a recurring "chalazion" in the same location that doesn't fully resolve should be evaluated to rule out sebaceous carcinoma, a rare eyelid cancer that can mimic a chalazion.

Should I avoid wearing makeup?

While you have an active chalazion, avoiding eye makeup reduces irritation and potential contamination. Resume once resolved, but keep makeup brushes clean.

References