Table of Contents
A chalazion is a bump on the eyelid, caused by a blocked oil gland. Chalazions do not typically cause pain, but they can make the eyes feel dry and itchy. In severe cases, a chalazion can cause blurry vision.
Chalazions are most common in people ages 30 to 50, but anyone can develop these bumps. People with blepharitis, which can also cause eyelid swelling, are at increased risk of developing a chalazion.
Conservative treatment, including warm packs and massage, are often enough to make a chalazion go away. But these treatments can take weeks or even months to work, and a chalazion can come back.
If the bumps do not go away with conservative care, there are other treatments doctors can try. They can use surgery to drain the blocked glands, or they can use steroid injections to reduce swelling so the oil can drain away.
What Is a Chalazion?
The upper and lower eyelids are dotted with glands that secrete a small amount of oil. That oil helps to lubricate the surface of the eye, so each blink can move smoothly across the surface of the eye.
Since these glands do such important work, it's not surprising that there are many of them. According to an article published in Review of Ophthalmology, there are about 20 or 30 of these glands lining the lower lid of one eye, and there are 40 or 50 lining the upper lid of one eye.
These glands are designed to be self-cleaning. They produce and expel oil at the same rate, so there is a constant slick of oil on the surface of the eye with no backup. But there are times when this system breaks down.
A chalazion forms when one of these glands becomes clogged. The gland continues to produce oil, but the clog prevents the oil from leaving the gland. In time, oil builds up and a bump forms.
According to the American Academy of Ophthalmology, chalazions rarely cause any kind of pain. But in time, a chalazion can grow large enough that it becomes noticeable to the naked eye. The bump can also grow so large that it presses on your eye, and that can cause blurry vision.
The American Society of Ophthalmic Plastic and Reconstructive Surgery reports that people with a chalazion may also feel as though the eye is dry, itchy, and uncomfortable. The blocked gland is not producing the oil that is required to keep the eye lubricated, and that can cause eye discomfort. Some people with a chalazion may also feel like they have something unusual sitting on the surface of the eye, and that sensation can also be uncomfortable.
How a Chalazion Develops
These eyelid bumps can happen to people of any age, but according to the American Optometric Association, they are most common in people ages 30 to 50. Other risk factors for these bumps include:
- A history of rosacea.
- Ongoing blepharitis, or inflammation of the eyelids.
- A history of seborrheic dermatitis.
The connection of chalazions to blepharitis is particularly telling. People with blepharitis have inflammation of the skin around the eyelashes, and that inflammation is accompanied by flaking and peeling. People with blepharitis are often encouraged to use warm compresses and frequent washing to reduce inflammation and to keep the eyes as healthy as possible. When those steps do not work and blepharitis continues unchecked, it can lead to a chalazion, according to the American Association for Pediatric Ophthalmology and Strabismus.
Proper Diagnosis Is Important
It might be easy to think you can diagnose a chalazion on your own at home. If you have a bump on your eyelid that does not seem to hurt but does seem to be growing over time, you might reasonably assume that you have a chalazion. It's important to know that a chalazion can look like other conditions, and some of those lookalike conditions can be quite dangerous.
For example, painless bumps on the eyelids can also be caused by cancer. According to the Skin Cancer Foundation, it is not at all uncommon for skin cancer to develop on both upper and lower eyelids. Typically, these cancers are basal cell carcinomas, and they can grow large enough to cause disfigurement.
Eyelid cancers can be treated, but the sooner they are addressed, the smaller the damage left behind. If someone mistakes a skin cancer tumor for a chalazion and delays treatment for that cancer by weeks or months, that can lead to the need for significant cancer treatment, which can be quite scarring.
Conservative Care Can Help
According to an article published by The BMJ, most chalazions will respond to conservative therapy, and typically, that therapy takes the form of twice-per-day warm compresses.
You will place a washcloth under warm — not scalding hot — water, wring out that washcloth, place it over the bump on your eyelid, and hold it in place for a few minutes. The heat helps to soften the plug that is blocking your gland, and that can allow some of the oil to move out of the gland so the bump can get smaller. Your doctor may also encourage you to gently massage the eyelid to encourage the oil to move out of the blocked gland.
As much as you might be tempted to do so, you should not squeeze or pinch the bump to force the oil out. Instead, you should use gentle pressure to allow the oil to move out of your eye slowly. Squeezing or pinching can drive oil deeper into the body and make the issue worse.
This conservative therapy works just as well as more invasive forms of treatment. For example, in a study published in the journal Acta Ophthalmologica, researchers found that 21 percent of people using hot packs alone had cured a chalazion in four to six weeks. By contrast, 12 percent of those using a topical steroid and hot packs got better. Sometimes, the simplest treatments really are best.
Treatment Options Are Available if Bumps Persist
While conservative therapy can help many people to get better, this form of treatment is not right for everyone. Some people need a bit more help in order to get real relief from these blocked glands.
One form of therapy involves a minor surgery. The doctor makes a very small incision and removes the oil from the inside, so there is no more bump to bother the eye. In a study of the efficacy of this form of therapy, published in the journal Ophthalmic Plastic and Reconstructive Surgery, researchers found that 78 percent of patients got better with just one procedure, while 86.7 percent got better with up to two procedures.
This research makes it clear that some people need multiple surgeries in order to really clear up the bump problem, but those who get them are able to move forward quickly.
A surgery like this is not painful. In fact, according to research published in the journal Advances in Ophthalmology and Visual System, using a topical anesthetic combined with an injectable anesthetic leads to pain scores of zero in patients. Research like this demonstrates that doctors have the expertise to keep pain under control during surgery, so people can get relief from their bumps without feeling intense pain at the same time.
Some people are very averse to surgery, and some chalazions are not quite large enough to merit a surgical response. Doctors can use injections of steroids, according to research published in the Pakistan Journal of Ophthalmology, to help these patients. The steroid helps to reduce overall inflammation within the eyelid, and that can help the accumulated oil within the gland to move out.
Your doctor can help you understand the treatment options available to remove the bump on your eyelid. You can discuss what therapies make you feel comfortable and what therapies do not seem right for you.
Your doctor may also discuss how you can prevent another bump from forming. Remember that you have many of these glands on both your upper and lower eyelids, and any of them can develop a chalazion. Your doctor may suggest that you perform a cleansing, a hot pack, and a massage every day for the rest of your life to keep this from happening to you again, or your doctor may suggest that you get treatment for the conditions that are associated with chalazion. If you have rosacea, for example, getting help for that condition could help to eliminate one of the risk factors that could lead to a future bump.
Choose a Doctor You Can Trust
Living with a chalazion is not easy, and you may be embarrassed to have an unsightly bump on your eyelid. You may also worry about the therapies that might be used to make the problem disappear, and you may have very strong opinions about the treatments you will or will not accept.
It is vital to work with a doctor you can trust. We can help. We have many doctors who would love to work with you, listen to you, and keep your eyes as healthy as they can possibly be. Reach out to find out more or make an appointment.
The Patient Experience
The Form and Function of Meibomian Glands. (May 2016). Review of Ophthalmology.
What Are Chalazia and Styes? (September 2017). American Academy of Ophthalmology.
Stye/Chalazion. American Society of Ophthalmic Plastic and Reconstructive Surgery.
Chalazion. American Optometric Association.
Chalazion. American Association for Pediatric Ophthalmology and Strabismus.
Focus on Eyelid Skin Cancers: Early Detection and Treatment. (September 2018). Skin Cancer Foundation.
Chalazion. (August 2010). The BMJ.
Conservative Therapy for Chalazia: Is It Really Effective? (January 2018). Acta Ophthalmologica.
Incision and Curettage Versus Steroid Injection for the Treatment of Chalazia: A Meta-Analysis. (May 2016). Ophthalmic Plastic and Reconstructive Surgery.
A Simple Anesthetic Technique to Eliminate Pain and Optimize Patient Satisfaction for Chalazion Incision and Curettage. (December2017). Advances in Ophthalmology and Visual System.
Effectiveness of Intralesional Triamcinolone Acetonide in the Treatment of Chalazion. (March 2015). Pakistan Journal of Ophthalmology.