[10] Chalazion

Question 1

What is a chalazion also known as?

Answer 1

Meibomian cyst

Question 2

What is a chalazion?

Answer 2

A focus of granulomatous inflammation in the eyelid arising from a blocked meibomian gland

Question 3

What is a meibomian gland also known as?

Answer 3

Tarsal gland

Question 4

What are meibomian glands?

Answer 4

Modified sebaceous gland located in the tarsal plates of the upper and lower lids

Question 5

What are the tarsal plates?

Answer 5

Two relatively tough elongated pieces of fibrous connective tissue which forms the infrastructure of the eyelid

Question 6

How many meibomian glands are there in each lid?

Answer 6

20-25

Question 7

What is the function of the meibomian glands?

Answer 7

To secrete meibum, the lipid component of the tear film

Question 8

What causes a chalazion?

Answer 8

Non-infectious drainage occlusion of the gland causing extravasation of meibum into the eyelid soft tissues

Question 9

What follows meibum outflow obstruction and extravasation in chalazion?

Answer 9

Focal secondary inflammatory reaction

Question 10

What are the risk factors for chalazion?

Answer 10

• Chronic blephritis
• Rosacea
• Seborrhoeic dermatitis
• Pregnancy
• DM

Question 11

How does a chalazion typically present?

Answer 11

Gradually enlarging, roundish, firm lesion in either the upper or lower lid

Question 12

Which lid is more commonly affected by chalazion?

Answer 12

Upper

Question 13

How big is a chalazion typically?

Answer 13

2-8mm in diameter

Question 14

Are chalazion painful?

Answer 14

No, but can be a little tender to start

Question 15

What is seen on evertion of the eyelid in chalazion?

Answer 15

A discrete, immobile, round, yellowish lump

Question 16

What should NOT be seen in chalazion?

Answer 16

• Ulceration
• Bleeding
• Telangiectasia
• Tenderness
• Discharge

Question 17

How doe chalazion typically resolve?

Answer 17

Drain through the inner surface of the eyelid and absorb spontaneously over 2-8 weeks

Question 18

How are chalazion diagnosed?

Answer 18

Clinically

Question 19

When may a chalazion require histological investigation?

Answer 19

In recurrent or atypical presentations

Question 20

How can a chalazion be differentiated from a stye?

Answer 20

• Overlying skin is more mobile
• Chalazion is small, non-tender and central VS stye is painful and localises to the margins
• Chalazion is a yellow swelling visible on evertion VS stye is small pustule at base of eyelash

Question 21

What are the differentials for chalazion?

Answer 21

• Internal or external stye
• Orbital or preseptal cellulitis
• Early herpes zoster
• Herpes simplex
• Tumour

Question 22

What tumours may present like a chalazion?

Answer 22

• Sebaceous gland carcinoma

- Skin cancer

Question 23

How can spontaneous resolution of chalazion be improved?

Answer 23

• Twice daily warm compression

- Massaging lids towards edge

Question 24

When should further intervention be considered for chalazion?

Answer 24

Progressively enlarging lesions

Question 25

What further interventions can be used in chalazion?

Answer 25

• Minor operation

- Triamcinolone

Question 26

What can be a potential complication of chalazion?

Answer 26

Large chalazion can cause astigmatism by pressing on the cornea