A chalazion, also known as a meibomian cyst, is a common condition affecting the eyelid. The fluid-filled swelling (cyst) is usually felt as a small lump. Occasionally, it can become infected. It is caused by blockage of a gland in the eyelid. If it is causing problems and does not settle on its own, it can be removed with a small operation.
What is a chalazion?
A chalazion is a small (2-8 mm) fluid-filled swelling (cyst) in the eyelid. It is common and sometimes called a meibomian cyst or tarsal cyst. A chalazion is more common on the upper eyelid and can affect both eyes. It is not the same as a stye.
What causes a chalazion?
There are tiny glands just under the inner surface of the eyelid. These make an oily fluid to help lubricate the eye. If the gland gets blocked then the fluid cannot escape and it may expand into a fluid-filled swelling (cyst). A chalazion is not normally infected. Over time, inflammation causes a nodule (or granuloma) to form. This is a firm, more solid lump that remains for a long time (is chronic). This lump is the chalazion.
A chalazion can occur following an internal stye (hordeolum). They are also more common in people who have the eye condition blepharitis, or skin conditions such as eczema. (See separate leaflets called Stye and Blepharitis for more information).
What are the symptoms of a chalazion?
- The usual symptom is a small lump which develops on an eyelid. It might look unsightly.
- Sometimes it causes mild pain or irritation, particularly if it has just started - this usually settles.
- Occasionally, it gets infected. It then becomes more swollen and painful.
- Sight is not affected. Rarely, it can become so big that it presses on the eyeball and distorts vision.
What is the treatment for a chalazion?
- No treatment may be advised at first. Between 1 in 4 and 1 in 2 people get better without any treatment. It can take quite a long time, between two and six months or more to resolve. However, if it is not causing you any problems, it is probably best to just to watch and wait.
- Hot compresses help to ease discomfort. Hold a clean flannel that has been in hot water gently but firmly against the closed eye. Do this for 5-10 minutes, 3-4 times a day. Sometimes this warmth and slight pressure is enough to soften the contents of the fluid-filled swelling (cyst), helping it drain more easily. (The water should be hot, but comfortable and not scalding.)
- Massage of the cyst after using a hot compress can encourage the cyst to drain. Do this gently, with a clean finger or cotton bud, in the direction of the eyelashes.
- Cleaning the eyelid twice per day removes grease and grime that may contribute to cysts forming. A weak solution of baby shampoo in warm water is ideal.
- A small operation is an option if it does not go, or if it causes troublesome symptoms. Your GP can refer you to an eye surgeon (ophthalmologist) for this. The operation is done under local anaesthetic. The eyelid is numbed. A small cut is then made on the inside of the eyelid to release the contents of the cyst. It is a minor procedure.
Note: antibiotic ointments, drops and medicines are not recommended as they do not make any difference - the contents of the cyst are infection-free (sterile).
Are there any complications?
Most fluid-filled swellings (cysts) cause few, if any, problems. Rarely, a cyst can become infected, and this infection can spread to involve the whole eyelid and tissues surrounding the eye. The eyelid may be very swollen and red, you might not be able to open the eye and you may have a lot of pain and a high temperature (fever). Sometimes the eyeball is pushed forward so that your eye sticks out more, and you may be very sensitive to the light. If you develop this type of complication, called orbital cellulitis, you need to see a medical professional urgently. Treatment of orbital cellulitis is with antibiotics, usually into a vein (intravenously) via a drip, in hospital.
Will it happen again?
For most people a chalazion occurs just once. However, some people are prone to developing them and it may come back (recur). You may be able to prevent it from recurring by using a hot compress on the eyelids (described above) and massaging the eyelids each morning.
Dr Tim Kenny
Dr Colin Tidy
Dr Olivia Scott