A chalazion is a chronic inflammatory granuloma (lipogranuloma) of the meibomian gland. It forms due to blockage of the meibomian gland's excretory duct and retention of lipid secretions.

bubble_chart Etiology

Due to chronic conjunctivitis, the excessive secretion of sebaceous and sweat glands or chronic inflammatory stimulation caused by blepharitis.

bubble_chart Pathological Changes

It is a granulomatous inflammation containing giant cells, initially characterized by the proliferation of glandular duct epithelial cells. The surrounding lymphocytes, giant cells, and abundant fibrous tissue are compressed to form a cystic wall, while the central tissue gradually degenerates into a colloid substance or even liquefies.

bubble_chart Clinical Manifestations

1. The disease progresses slowly, usually without obvious symptoms, and there is no pain. Sometimes there is only a feeling of heaviness. It may cause temporary astigmatism due to pressure from the mass or a foreign body sensation due to pressure on the eyeball.
2. One to several round masses of varying sizes can be palpated under the eyelid skin, ranging from as small as a grain of rice or a mung bean to as large as a soybean or cherry. The surface is smooth, not adhering to the skin, with clear edges and no tenderness.
3. When the eyelid is everted, the mass can be seen as a localized purple-red or gray-red protrusion on the conjunctival surface. If secondary infection occurs, it may develop into a hordeolum, making it difficult to distinguish from an internal hordeolum in terms of formation.
4. Small masses may completely resolve on their own or spontaneously rupture through the conjunctival surface, discharging gelatinous contents and forming mushroom-like granulation tissue proliferation. This granulation tissue can also proliferate through the excretory ducts of the tarsal glands, forming papillary growths on the eyelid margin.
5. When secondary infection occurs, it may develop into an internal hordeolum.
6. For elderly patients, especially those with postoperative recurrence, the excised specimen should be sent for pathological examination to rule out the possibility of tarsal gland carcinoma.

bubble_chart Diagnosis

1. No subjective symptoms, with a nodular elevation under the eyelid skin, no tenderness, and no adhesion to the skin. Upon everting the eyelid, the conjunctiva opposite the cyst appears purplish-red or grayish-white (the cyst may rupture through the conjunctival surface, exposing granulation tissue).
2. For recurrent cases, pathological examination should be performed to differentiate it from meibomian gland carcinoma.

bubble_chart Treatment Measures

1. For smaller early-stage chalazion, hot compresses or tuina therapy can be used to promote dissipation and absorption.
2. Injecting 0.3–0.5ml of prednisolone around or inside the cyst can facilitate absorption and achieve good results.
3. Surgical treatment: Small cysts do not require treatment, while large chalazions can be surgically removed. During the procedure, the cyst wall must be completely excised to prevent recurrence. The incision should be made vertically on the conjunctival membrane surface. If granulation tissue protrudes from the conjunctival membrane, it should be excised simultaneously.