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Updated: May 18 2022


  • Snapshot
    • A 55-year-old man presents to the ophthalmologist with complaint of a painless "nodule" on the inner surface of his lower eyelid. He denies any pain in the area, and it has not affected his vision. Physical examination is notable for a small chalazion. He is instructed to apply warm compresses to the eye area multiple times a day.
    • Chalazion presents as a painless eyelid nodule
      • caused by the obstruction of the sebaceous glands in the eyelid
    • Diagnosis is made clinically based on exam finding of a painless eyelid nodule
    • Treatment involves applying warm compresses to the eye, as chalazia typically self-resolve
  • Epidemiology
    • Risk factors
      • blepharitis
        • inflammation of the eyelid
      • rosacea
      • prior chalazion
    • Pathophysiology
      • obstruction of the Zeis or meibomian glands of the eyelid
        • thickened secretions lead to blockage of glands, producing a granulomatous inflammatory response
  • Presentation
    • Symptoms
      • eyelid discomfort from swelling
      • eyelid pain in cases of secondary infection
    • Physical examination
      • painless nodule located in the inner eyelid
  • Studies
    • Slit-lamp examination
      • evaluation of the meibomian glands
  • Differential
    • Hordeolum (stye)
      • key differentiating factor
        • results from acute purulent inflammation of the eyelid glands
        • painful
    • Sebaceous carcinoma
      • key differentiating factors
        • causes persistent or recurrent lesion
        • biopsy results demonstrate vacuolated cytoplasm and high mitotic activity
  • Treatment
    • Lifestyle
      • warm compresses
        • indication
          • to facilitate drainage of chalazia
    • Surgical
      • incision and curettage
        • indication
          • persistent or recurrent chalazion
          • pathological analysis of specimen to rule out sebaceous cell carcinoma
  • Complications
    • Acute secondary infection
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