Chalazion

This presentation describes the clinical aspects of chalazion

1. Chalazion BY Dr. Amr Mounir Lecturer of Ophthalmology Sohag University

2. Chalazion Introduction : It is a chronic nonspecific inflammatory granuloma of meibomian gland ( lipogranuloma ). The most common inflammatory lesions of eyelid (approximately 13% of all benign eyelids lesions) More common in adults than children

3. It is often starting out as a very small red, tender, swollen area of the eyelid. Meibomian glands are a sebaceous glands found in eyelids. They secrete oily component of tears.

4. Etiology: May be produced by: Chronic irritation by a low virulent organism Retention content of the gland following obstruction of the gland by: Proliferation of epithelium ( vitamin A deficiency ). Dry secretions. Foreign body reaction ( granulomatous reaction ).

5. Pathology: Chronic granulomatous reaction with numerous lipid-filled giant cells. Typically, the nuclei of these cells are located around a central foamy cytoplasmic area that contains the ingested lipid material.

6. Clinical picture: SYMPTOMS Painless Swelling lid. Slowly progressive. Heavy feeling. Blurring of vision. Pain occurs only if it becomes infected.

7. SIGNS Painless swelling 4-5 mm average from lid margin. Swelling is hard on conjunctival side. it appears red or purple. In long standing lesion it appears grey. In old lesion granulation tissue turns into jelly- like mass.

8. Fate of chalazion: Spontaneous resolution. Complications.

9. Complications: 1) Infection of Chalazion 2) Astigmatism. 3) Recurrence. 4) Loss of eyelash

10. 5) Protrusion on conjunctival side lead to irritant granuloma. 6) Multiple chalazion in upper lid leading to mechanical ptosis. 7) Cyst formation: tarsal or meibomian cyst.

11. Differential diagnosis: Adenoma of meibomian gland Sebaceous gland carcinoma Stye from infected chalazion

12. TREATMENT: Home treatment Chalazion usually requires very little medical treatment and tends to clear up on its own within a few weeks. Warm compress Applying a warm compress to affected eye can help soften and hardened oil blocking the gland ducts.

13. Surgical treatment Small chalazion: local antibiotic, vitamin A and steroid. Marginal chalazion: scraping from lid margin. Moderate or large chalazion: Vertical incision and curettage through conjunctival side.

14. Intralesional or subcutaneous injection of soluble steroids. Recurrent chalazion of the same gland: excision biopsy to exclude malignant tumor .

15. Thank you