Chalazion (”internal stye”)

A chalazion is a painless lump that appears on the upper or lower eyelid, formed when one of the sebaceous glands in the eyelid becomes blocked and cannot drain oil properly. These glands contribute to maintaining the tear layer, which helps protect the eye from dryness and infection. When a gland becomes blocked, the oil remains trapped inside it and causes swelling. A chalazion in the eye does not cause pain unless an infection develops in the area, and often resolves on its own with conservative treatment. However, when the swelling persists and does not respond to treatment, surgical removal should be considered.

Note that it is important to distinguish between a chalazion and a stye, two conditions that may look similar but differ from each other. While a chalazion is caused by a non-inflammatory blockage of a sebaceous gland in the eyelid, a stye is an infectious inflammation that occurs when a sebaceous gland becomes infected with bacteria. A stye tends to be very painful and causes redness and hot swelling in the eyelid. Over time, a stye can drain itself and heal, while a chalazion remains unchanged and sometimes requires additional treatment or surgery for removal.

There are various and diverse causes for a chalazion:

1. Poor hygiene – Insufficient cleaning of the eyelid area causes accumulation of oil, dirt, and bacteria in the openings of the sebaceous glands. This phenomenon is more common among people who do not maintain daily cleanliness of the area, such as not removing makeup before sleep.
2. Recurrent eyelid inflammation (blepharitis) – Blepharitis is a chronic inflammation accompanied by swelling and redness in the eyelids. When the inflammation is not treated, it can cause blockage of the sebaceous glands. People who suffer from frequent eyelid inflammations are at higher risk of developing a chalazion.
3. Use of makeup products around the eyes – Makeup products can clog the sebaceous glands if they are not regularly removed. Moreover, prolonged use of old makeup products or those containing irritating ingredients can lead to the accumulation of residues that cause infection and inflammation in the eyelids.
4. Certain skin diseases – Skin diseases such as rosacea increase the risk of chalazion. Rosacea is a disease characterized by chronic redness and the formation of small pimples on the skin, and its effects on the sebaceous glands can lead to the appearance of chalazion in the eyelids.
5. Hormonal changes – Hormonal changes cause changes in the activity of the sebaceous glands. For example, pregnant women, those undergoing hormonal treatments, or those suffering from hormonal imbalance may find themselves at increased risk for chalazion.

• A chalazion is usually not painful, but when it becomes infected, it can become a painful nuisance. Symptoms include localized swelling in the eyelid, a feeling of a small lump in the upper or lower eyelid, and sometimes redness in the area. In rare cases, an especially large chalazion may put pressure on the cornea and cause temporary blurred vision. Additionally, a chalazion can be an aesthetic nuisance and cause discomfort regarding one’s external appearance.

In the initial stages, treatment for a trapped stye includes warm compresses on the eyelid and gentle massage. Using warm compresses several times a day may help open the blockage of the sebaceous gland and solve the problem independently. In some cases, the doctor may recommend antibiotic eye drops or antibiotic ointment to help prevent infection or to reduce swelling.

If a chalazion does not respond to conservative treatment, the doctor may recommend injecting steroids directly into the swollen area, an action that reduces inflammation and helps absorb the fatty lump. In more stubborn cases where all these methods fail, chalazion surgery may be considered.

Surgery to remove a chalazion is a short and simple procedure performed under local anesthesia. The doctor makes a small incision in the eyelid and drains the contents of the chalazion. The surgery usually lasts only a few minutes and does not involve hospitalization. In children, the surgery is performed under general anesthesia, and the child’s parents can stay with them until the anesthesia begins.

The risks in surgery to remove a trapped stye are very rare and include local infection, bleeding, and swelling. In most cases, stitches are not required to close the incision.

After chalazion removal surgery, the recovery process is usually short and includes several basic instructions aimed at ensuring quick healing and preventing complications. After the surgery, which is performed under local anesthesia in adults and general anesthesia in children, the patient will be discharged home with a light bandage on the eye. The bandage can be removed after a few hours, according to the doctor’s instructions. In the first hours after surgery, mild discomfort or moderate pain may occur in the eyelid area, but these can be relieved with painkillers.

The eyelid area may be swollen and red for several days, and sometimes mild bruising may appear around the eyelid. These side effects are temporary and disappear within one to two weeks. During the recovery period, it is important to avoid rubbing or irritating the eyelid and to maintain hygiene in the area. The eyelids can be gently cleaned with warm water and mild soap; there are special wipes for cleaning the eyelids that are recommended for use after surgery.

It is important to follow the doctor’s instructions regarding the use of antibiotic or steroid eye drops, which are given in certain cases to prevent infections and reduce inflammation. Activities that may put strain on the eye, such as swimming in a pool, using wet facilities (such as a sauna or jacuzzi), and makeup in the eye area, should be avoided during the first two weeks after surgery.

An initial follow-up is usually scheduled one week to one month after surgery, depending on the patient’s condition, to ensure that recovery is progressing properly and that there are no signs of recurrence of the chalazion.

A chalazion is a common condition that can be managed with conservative treatment or through a surgical procedure for its removal, depending on the patient’s condition. The surgery is short and simple, and allows the eyelid to return to full function and normal appearance. If you suffer from chronic swelling in the eyelid that does not respond to conservative treatment, it is recommended to consult an ophthalmologist who will assess the situation and recommend the most appropriate treatment.

At the Dr. Levinger Eyes Medical Center, we will be happy to provide you with professional and personal consultation for the diagnosis and treatment of chalazion, tailored to your needs. We invite you to contact us and begin the process that will help improve the comfort of your eyelids and maintain your eye health. Our team of experts is available to answer any questions and provide you with the necessary information regarding treatment options, whenever you want.