Chalazion

Introduction to Chalazion, characteristics, risk factors, marginal chalazion, general pathology, pathogensis, course(fate) of chalazion, diagnosis, differential diagnosis, treatment, home treatment, over-the-counter treatmnent, surgery, complications, prevention ..

1. CHALAZION MARIA SAEED

2. A chalazion is a slowly developing lump that forms due to blockage and swelling of an oil gland in the eyelid. A chalazion is generally not an infection. It often starts out as a very small red, tender, swollen area of the eyelid. In a few days, it may change to a painless slow-growing lump the size of a pea.

3. Characteristics of a chalazion: Painless bump. Caused by a thickening of the fluid in the oil glands (meibomian glands) of the eyelid. Tearing and mild irritation. Blurred vision. More common in adults than children; most frequently occurs in people aged 30-50.

4. Risk factors Acne rosacea Chronic blepharitis (inflammation of the eyelids, often from excess bacteria) Seborrhea Tuberculosis Viral infection Rarely, they may be an indication of an infection or skin cancer

5. Marginal chalazion Nodules, but infected chalazia may result in preseptal cellulitis. Marginal chalazia are those located at the eyelid margin and usually result from superior extension (of a lower lid chalazion) beyond the lid margin or inferior extension (of an upper lid chalazion) beyond the lid margin.

6. It is also reddish nodule like chalazion. The clinical features, fate, and treatment is similar to chalazion.

7. Pathophysiology

8. General Pathology Microscopic study shows chronic granulomatous inflammation compromised of multinucleated giant cells and epithelioid cells surrounding a lipid globule. Neutrophils , lymphocytes and plasma cells may are often present.

9. Pathophysiology Meiboiman glands are a sebaceous glands found in eyelids. They secrete Oily components of tears. Chalazia are inflammatory lesions that form due to stasis of gland secretion with resultant inspissation of gland orifice and incite a granulomatous inflammatory response . C onjunctival granuloma . Meibomian glands are embedded in the tarsal plate of the eyelids; therefore, edema due blockage of these glands is ordinarily contained to the conjunctival portion of the lid .

10. Cont.. A chalazion may enlarge and break through the tarsal plate to the external portion of the lid. Chalazia due to blockage of Zeis glands are usually located along the lid margin . The Zeis gland inflammation is termed as External Chalazion. The Meiboiman gland inflammation is termed as Internal Chalazion .

11. Cont.. Chalazia differ from hordeola in that they form as a result of gland obstruction and sterile inflammation rather than infection. A chalazion is characterized by a mass of granulation tissue and chronic inflammation (with lymphocytes and lipid-laden macrophages), an internal or external hordeolum is primarily represent acute focal infectious process with necrotic debris i.e: abscess.

12. Fate(Course) of Chalazion Once chalzaion is developed then it may follow one of the following course : Spontaneous complete resolution may occur . Liquify to form a thin fibrous sac containing a gliary fluid called Meibomian cyst. Get fibrosed into hard nodule. Calcify and form a very hard nodule . Get infected and suppurate. Burst through the conjunctiva and present as fleshy mass.

13. Clinical features

14. CLINICAL FEATURES It is painless gradually increasing swelling in the eye lid without external signs Palpitation indicates small nodule in the substance of the eyelid Eversion of the eye lid shows that the conjunctiva is red or purple over the nodule There may be fleshy mass if the lesion has ruptured through the conjunctiva Blurred vision may occur due to astigmatism caused by large chalazion of upper eyelid pressing the cornea

15. Diagnosis

16. Diagnosis A chalazion is best diagnosed by eye doctor who can advise you on treatment options. Necessary testing might include : Patient history   to determine symptoms and the presence of any general health problems that may be contributing to the eye problem . External examination of the eye , including lid structure, skin texture and eyelash appearance . Evaluation of the lid margins , base of the eyelashes and oil gland openings using bright light and magnification

17. Differential Diagnosis Sebaceous gland adenoma Sebaceous gland carcinoma Sarcoid granuloma Dermal tuberclosis Fungal infection Foreign body granuloma.

18. TREATMENT

19. Home Treatment A chalazion usually requires very little medical treatment and tends to clear up on its own within a few weeks . There are several safe ways to promote drainage and speed up the healing process. These include : Warm Compresses. Gentle Massage. Over-the-Counter.

20. Warm compresses Applying a warm compress to the affected eye can help soften any hardened oil blocking the gland ducts. To make and use a warm compress: Soak a soft, clean cloth or cotton pad in a bowl of warm water. Wring out any excess liquid. Apply the damp cloth or pad to the eyelid for 10–15 minutes. Continue wetting the compress often to keep it warm. Repeat this several times a day until the swelling goes down.

21. Gentle massage Gently massaging the eyelids for several minutes each day can help the oil ducts drain more effectively . Before doing so, ensure that the hands are clean to reduce the risk of infection . Once the chalazion begins to drain, keep the area clean and avoid touching it with bare hands.

22. Over-the-counter treatments A number of over-the-counter products can help treat a chalazion or stye. These may reduce irritation, prevent infection, and speed up the healing process . Some of these products include: Ointments Solutions M edicated eye pads .

23. Surgery It is the most common method of treatment. The lesion is incised and contents are curetted from conjunctival side by vertical incision

24. Complications

25. Complications Potential complications of chalazia include: lash loss lid notching other cosmetic deformity adjunctive infections leads to the development of hordeolum preseptal cellulitis

26. Cont.. Improperly drained marginal chalazia can result in trichiasis and loss of lashes. Partially drained chalazia can result in large masses of granulation tissue prolapsing through the conjunctiva or skin .

27. Cont.. Visual disturbances can occur with large chalazia that causes pressure on Cornea and astigmatism may arise when the lid mass distorts the corneal contour.

28. Cont.. A large chalazion can cause  Astigmatism  due to pressure on the cornea .

29. Prevention

30. Prevention: Cleansing the eye area every day can help prevent a chalazion from developing or recurring. Using premoistened cleansing wipes to keep the oil glands from becoming blocked . Avoid rubbing the eyes. Protecting the eyes from dust and air pollution. e.g: by wearing sunglasses when outdoors. Replacing eye makeup every 6 months to prevent bacterial growth.