Clinical Reference Systems: Pediatric Advisor 10.0

DESCRIPTION (Diagnosis must be confirmed by a physician.)

• There is a lump in the middle of the eyelid.
• The lump slowly gets bigger until it is about 1/2 inch wide.
• The skin overlying the lump is a normal color or pink.
• The lump is usually not tender.

This diagnosis requires examination by a physician.

CAUSES

A chalazion is caused by a blockage of a special oil gland called the meibomian gland. The oil gland normally provides lubrication to the inner surface of the eyelid. When the gland is blocked, the oily material accumulates and causes a lump in the eyelid. The gland can become blocked by infection, dust, a foreign body, or trauma.

If a chalazion is caused by infection, the culprit is usually staphylococcus bacterium.

EXPECTED COURSE

If a chalazion is treated within the first month or so, the antibiotics and eyelid massage may reduce the swelling. After the first month, treatment is of little benefit, but the lump may gradually disappear on its own. Occasionally, the blocked gland opens through the inner lining of the eyelid and drains a little pus for a day or so before it heals over.

If the chalazion is large and lasts more than 5 or 6 months, it usually needs to be opened and drained by an eye surgeon (an ophthalmologist).

RELATED TOPIC: STYE

Styes are different from chalazions because they are located on the eyelid margin and drain without any treatment within a few days.

For more information see Stye.

TREATMENT

1. Antibiotic eyedrops or ointment (available by prescription)

   Your child needs the antibiotic eyedrops or ointment prescribed by your physician.

   If your physician has prescribed eyedrops, gently pull down on the lower eyelid and place two drops inside the lower lid. Have your child then close his eyes for 2 minutes, so the eyedrops will stay inside. If it is difficult to separate your child's eyelids, put the eyedrops over the inner corner of the eye while he is lying down. When your child opens his eye and blinks, the eyedrops will flow in.

   If your physician has prescribed eye ointment, separate the eyelids and put in a small ribbon of ointment along the lower eyelid from one corner of the eye to the other. If it is difficult to separate your child's eyelids, put the ointment on the edges of the eyelids. As the ointment melts, it will flow onto the eyeball.

2. Hot compresses and eyelid massage

   The purpose of eyelid massage is to help open the blocked gland. First put a warm wet cloth on the eyelid for 2 or 3 minutes. Then, using your finger or a cotton swab, gently massage the swollen area downward towards the edge of the eyelid. Do this for about 1 minute. Repeat this process four times a day just before you put the antibiotic eyedrops or ointment in your child's eye.

CALL YOUR CHILD'S PHYSICIAN DURING OFFICE HOURS IF:

• The chalazion doesn't get smaller after you have treated it for one month with antibiotic eyedrops (or ointment) and massage.
• The swelling becomes larger.
• Your child still has the lump more than 5 or 6 months from now.
• The eyelid becomes red and swollen.
• You have other questions or concerns.