Causes and risk factors
The narrow opening through which a meibomian gland secretes its oily substance becomes obstructed. This is caused due to narrowing of the opening or hardening of the sebaceous substance near the opening. This leads to accumulation of the oily or lipid substance causing swelling. There is thickening of the walls of the gland and leakage of lipid into the lid itself, causing inflammation both within the gland and the eyelid. Irritation of mucosal lining leads to cellular infiltration with formation of giant cells. There is proliferation of fibroblasts which causes granuloma formation. This condition is called as a chalazion. It is commonly seen in children and young adults. Diseases that predispose to this condition include blepharitis, chronic conjunctivitis, diabetes mellitus, and refractory errors.
Clinical presentation
Patient complains of a lump on the eyelid. There is painless nodular swelling of the eyelid. Swelling is of pea size. It is firm, tense, and nontender. There is increased watering of the eyes. Patient experiences blurred or blocked vision. There is sensitivity to light. Drooping of the eyelid occurs if the chalazion is large enough. On eversion of eyelid, tarsal conjunctiva beneath the nodule is velvety red or purple and slightly elevated.
Investigation
Medical history by the patient and clinical examination by the ophthalmologist helps in diagnosis. Regular eye checkup is recommended. Routine blood tests are advised.
Treatment
Treatment involves hot fomentation. Steroid – antibiotic eye ointment with lid massage is useful in case of small chalazion. Intralesional injection helps in treating the condition. In case of moderate to large chalazion, surgical intervention like incision and drainage of the chalazion under local anaesthesia is required. In marginal chalazion, drainage of the chalazion manually is done. Electrocoagulation may be required.
Other Modes of treatment
The other modes of treatment can also be effective in treating chalazion. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating chalazion.
