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  • Chronic sterile lipogranuloma originating from the meibomian glands
  • Palpable nodule on the eyelids , usually not painful


  • 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


  • 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)