Chalazion

Chalazion is also called a tarsal or meibomian cyst. It is a chronic non-infective granulomatous inflammation of the meibomian gland.

Etiology/Cause

1. Predisposing factors:

• • It is more common in children and young adults (though no age is bar) and in patients with eye strain due to muscle imbalance or refractive errors.
  • Habitual rubbing of the eyes or fingering of the lids and nose
  • chronic blepharitis
  • diabetes mellitus
  • Metabolic factors: chronic debility, excessive intake of carbohydrates and alcohol also act as predisposing factors

2. Pathogenesis

Usually, first there occurs mild grade infection of the meibomian gland by organisms of very low virulence. As a result, there occurs proliferation of the epithelium and infiltration of the walls of the ducts, which are blocked. Consequently, there occurs retention of secretions (sebum) in the gland, causing its enlargement. The pent-up secretions (fatty in nature) act like an irritant and excite non-infective granulomatous inflammation of the meibomian gland.

Clinical picture

• Patients usually present with a painless swelling in the lid and a feeling of mild heaviness.
• Examination usually reveals small, firm to hard, non-tender swelling present slightly away from the lid margin.
• It usually points on the conjunctival side, as a red, purple or grey area, seen on everting the lid.
• Rarely, the main bulk of the swelling project on the skin side. Occasionally, it may present as a reddish-grey nodule on the intermarginal strip (marginal chalazion). Frequently, multiple chalazia may be seen involving one or more eyelids.

Clinical course and complications

• Complete spontaneous resolution may occur rarely.
• Often it slowly increases in size and becomes very large. A large chalazion of the upper lid may press on the cornea and cause blurred vision from induced astigmatism. A large chalazion of the lower lid may rarely cause a version of the punctum or even ectropion and epiphora.
• Occasionally, it may burst on the conjunctival side, forming a fungating mass of granulation tissue.
• Secondary infection leads to formation of hordeolum internum.
• Calcification may occur, though very rarely.
• Malignant change into meibomian gland carcinoma may be seen occasionally in elderly people.

Treatment

Auxiliary measures which can be of help:

•  Using a warm compress as it helps to reduce the inflammation and may help to soften the hardened gland.
•  Avoid wearing eye makeup and contact lenses during the acute phase of infection/ till the chalazion get better.
•  Do not squeeze eyelid or chalazion. Do not rub your eyes.
• Gently massage the eyelids for a few minutes. It will help the ducts of the oil gland drain more effectively

For cases which get recurrent Chalazion following tips may be helpful:

• Wash your hands before touching your eyes.
• Clean your contact lenses, glasses properly before using it.
• Avoid eye makeup.
• Wash your eyes with the cold water few times a day.
• Eat healthy food to boost your immunity

1. Conservative treatment: In a small, soft and recent chalazion, self-resolution may be helped by conservative treatment in the form of hot fomentation, topical antibiotic eye drops and oral anti-inflammatory drugs.
2. Incision and curettage is the conventional and effective treatment for chalazion which is large and need surgical intervention.
3. Diathermy: A marginal chalazion is better treated by diathermy.

Scope of Homeopathy

Oral Homeopathic medicines aid to resolve the swelling and infection of chalazion. Homeopathic medicines help in controlling the infection when given on symptomatic basis of totality. Homeopathic oral medicines can be added along with Eye drops being prescribed for condition. Recurrent Chalazion or tendency can also be helped by a rightly chosen totality based medicine. Medicines need to be taken under the guidance of an expert homeopath.

Medicines for Chalazion⁴