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Definition
- Chronic sterile lipogranuloma originating from the meibomian glands
- Palpable nodule on the eyelids , usually not painful
Therapy
- Application of warm compresses several times daily e.g. with hot/cold packs), with eyelid massage and hygiene
- Fucithalmic gel (Fusidic acid) 2x/day
- In case of persistent chalazion: ab interno incision + curettage (+ histology)
- alternatively: Steroid injection possible in case of poorly encapsulated or small findings (Cave: skin depigmentation, fat atrophy)
- In case of recurrent hordeola:
- Eyelid hygiene
- Minocin Acne 50mg 2x/d for 1 week, then 1x/d for 5 weeks (take approx. 1h before meals).
- Contraindication: renal and hepatic insufficiency, pregnancy, children under 8 years of age
- Alternatively: azithromycin 110mg 1-0-0 for 4-6 weeks.
Cave Children
- Chalazion on the upper eyelid can lead to amblyopia!
- Autorefraction: Astigmatism?
- Pupil covered?
Differential Diagnosis
- Hordeolum: acute (bacterial) infection of the meibomian or zeis glands, “sty”, painful
- Sebaceous gland carcinoma: In case of unclear recurrent chalazion, always take a biopsy!
- Preseptal Cellulitis: in case of pronounced eyelid swelling
Sources
- EyeWiki Chalazion
- The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7. Edition (2016)
- Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8. Edition (2015)