Chalazion (Meibomian Cyst)

What is Chalazion (Meibomian Cyst)?

A chalazion is a benign, localised swelling within the eyelid caused by obstruction of a meibomian gland — one of many small oil-secreting glands that line the upper and lower lid margins. Unlike a stye (hordeolum), which is an acute infection, a chalazion is typically a painless, slowly enlarging lump. Most chalazia resolve with conservative treatment, but larger or persistent ones require minor surgery.

Symptoms

• A firm, painless lump in the upper or lower eyelid
• Mild swelling of the surrounding eyelid
• Blurred vision if the cyst is large enough to press on the cornea
• Occasional redness and tenderness if secondary infection develops

Causes

• Obstruction of a meibomian gland duct, often in the context of blepharitis
• Rosacea — a skin condition associated with meibomian gland dysfunction
• Previous chalazion — recurrence at the same site is common
• Rarely: a recurrent chalazion at the same site may indicate a sebaceous cell carcinoma (always biopsy on third recurrence)

Diagnosis

Clinical examination. In cases of recurrent or atypical lesions, histopathological examination of surgically excised tissue is performed to exclude malignancy.

Treatment

Warm compresses applied for 10 minutes twice daily, combined with lid massage, resolve many early chalazia. If the cyst persists beyond 4–6 weeks or is causing visual symptoms, incision and curettage under local anaesthetic provides rapid and definitive resolution.