Chalazion (eyelid cyst)

Published by Bupa's Health Information Team, September 2010.

This factsheet is for people who have a chalazion, or who would like information about it.

A chalazion is a cyst (a small sac of fluid) on the inside of the eyelid. It's also called a meibomian cyst. A chalazion looks similar to a stye and can grow to the size of a pea.

About a chalazion

A chalazion is a blocked meibomian gland in your eyelid. The meibomian glands are in the middle of your eyelid, just behind your eyelashes. There are between 50 and 70 glands in each eyelid. The meibomian glands help to keep your eyes moist by preventing the watery layer on the surface of your eyes (tears) from evaporating. They do this by producing an oily film over your tears.

A chalazion is a common eye problem. It affects all age groups but is more common in adults than in children. A chalazion is more likely to develop on your upper eyelid. Once you have had a chalazion you're more likely to keep getting them.

When there is more than one chalazion then they are called chalazia.

Symptoms of a chalazion

A chalazion usually looks and feels like a stye to begin with. It starts with a swollen, painful and irritated eyelid. This quickly settles and a hard painless lump then develops.

When your eyelid is lifted up and turned inside out you may see a smooth yellow cyst. The outside of your eyelid can look normal and the affected area isn't painful to touch. However, if your chalazion grows very large, it may become painful.

If the lump grows very large, it can press on your cornea, the clear dome that forms the front of the eyeball, and can cause blurred vision. If you have any of these symptoms, you should see your GP.

Complications of a chalazion

Occasionally, if a chalazion is large it can put pressure on your cornea, forcing it to change shape and causing astigmatism. This means your cornea is no longer perfectly round. Instead it's oval, a bit like a rugby ball. Because of this, light entering your eye isn't focused properly, which causes blurred vision.

Causes of a chalazion

A chalazion is caused by a blockage in a meibomian gland in your eyelid.

Most chalazia have no clear underlying cause but the gland may become blocked because of an infection, such as a stye, or an abnormal growth, such as a tumour (although this is rare). Skin conditions that cause infection or inflammation, such as seborrhoeic dermatitis or rosacea, can also cause blocked glands.

Many blockages resolve by themselves, and the fluid trapped inside drains away naturally. However, if this doesn't happen, a chalazion forms.

Diagnosis of a chalazion

Your doctor will ask about your symptoms and examine your eye. He or she may also ask you about your medical history.

Treatment of a chalazion

Around one in four chalazia get better on their own within six months and won't need any treatment. However, if your chalazion doesn't go away by itself, there are several treatments available.

Self-help

A hot compress, followed by an eye massage, may help remove the blockage and release the fluids trapped inside the cyst.

Use a towel soaked in hot water to make a compress. The water you use shouldn't be scalding hot - the compress should feel comfortable on your skin. Put this over your eyelid for a few minutes. This will warm the fluids trapped inside the cyst.

Massage your eyelid by gently rolling your finger upwards if the chalazion is in your lower lid or downwards if the chalazion is in your upper lid. You should do this for about a minute. The massage will help to remove the blockage and release the trapped fluids.

Try to use a hot compress and massage every day.

Steroid injection

A steroid injection can be used to treat a chalazion. This reduces inflammation within one to two weeks of having the injection. Your doctor will inject the steroid directly into the centre of your chalazion through the lining of the inside of the eyelid. You may be given a local anaesthetic to numb the area around the chalazion and block any feeling from your eyelid.

Surgery

If your chalazion is very big or uncomfortable, or if it keeps coming back you may need to have it surgically removed. This is done using a procedure called incision and curettage.

The procedure is usually done as an outpatient or day case at the hospital. A local anaesthetic is used to completely block feeling from your eye area and you will stay awake during the operation which lasts around 20 minutes.

To remove your chalazion, your surgeon will turn your eyelid inside out and put a small clamp around it. He or she will then make a small cut to the inside of your eyelid and remove the contents of the gland. After the procedure, you will be given an antibiotic ointment to use. Your eyelid may be swollen and bruised for up to a week after the operation.

If you have a chalazion that keeps coming back despite treatment, it's important to see your GP. Occasionally, a chalazion can be caused by another underlying condition such as a skin disorder or, very rarely, the lump may be cancer (a malignant tumour).

Video

See our video about caring for your eyelids:

• Caring for your eyelids

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.