A meibomian cyst (also known as chalazion) arises when the outflow of the meibomian glands in the eyelids is blocked, leading to the accumulation of the secretions produced and the formation of a cyst [1] [2] [3] [4]. It is defined as a benign lipogranulomatous collection that develops from non-infectious causes, which is the crucial feature distinguishing it from a stye, which is formed because of a bacterial infection [4] [5] [6]. The clinical presentation is characterized by the appearance of a painless lump on the eyelid that grows over a period of days or weeks [1] [2]. The lump exhibits a variable degree of tenderness, swelling, and redness (depending on the stage) that often overlaps with the presentation of a stye, but all of the aforementioned signs eventually subside [1] [4]. Both upper and lower eyelids may be the location of a meibomian cyst, which can sometimes appear in multiple sites [4]. In some cases, the cyst may be large enough to induce mechanical ptosis or astigmatism, leading to symptoms such as blurred vision and deficits in the visual field [1] [4]. A cosmetic discomfort is also an important complaint and is often the main reason for a visit to the physician [4]. Several cutaneous disorders have been associated with an increased risk for meibomian cyst formation, including rosacea, seborrheic dermatitis, and blepharitis [1] [4].

• Inflammation

  An alternative to surgery involves administering a steroid injection into the affected gland to reduce the inflammation. [medicinenet.com]

  Styes are caused by an inflammation or infection in the eyelash follicles or oil glands at the base of the eye lashes. Stye can contain the same bacteria that causes staph infections, and can be quite painful. [kadrmaseyecare.com]

  This rapidly leads to resolution of the inflammation, and re-establishment of normal glandular function in the lids. [bopss.co.uk]

  Inflammation of a tarsal meibomian gland leads to a deep chalazion, whereas inflammation of a Zeis gland leads to a superficial chalazion. [emedicine.medscape.com]

• Fever

  Because internal hordeola are so rare, they are not usually suspected unless inflammation is severe or fever or chills are present. [msdmanuals.com]

  Occasionally, headache and fever might occur A progressively growing Chalazion may place adverse pressure on the eye ball, or even cause a temporary disruption in vision. [dovemed.com]

  Inflammation may be severe, sometimes with fever or chills. Spontaneous rupture occasionally occurs, on the conjunctival side. Differential diagnosis Infections Internal hordeolum. External hordeolum. Orbital or preseptal cellulitis. [patient.info]

• Asymptomatic

  A small asymptomatic cyst can be safely left alone[3]. A simple chalazion does not need treatment with antibiotics, even if it is very large[1, 3]. Some lesions get progressively larger and simple lid hygiene techniques don't help. [patient.info]

  ‘if the meibomian cyst does not improve or resolve after 4 weeks with conservative treatment offer the following options (depending on clinical judgment and the person's preference): a) No treatment — for example, if the meibomian cyst is small and asymptomatic [valeofyorkccg.nhs.uk]

  Google Scholar | Crossref | Medline Filips RF, Liudahl JJ Asymptomatic posterior orbital cellulitis resulting from ethmoid/maxillary sinusitis. J Am Optom Assoc. 1997 ;68: 55 - 60. Google Scholar | Medline Starkey C., Steele R. [dx.doi.org]

• Chills

  Because internal hordeola are so rare, they are not usually suspected unless inflammation is severe or fever or chills are present. [msdmanuals.com]

  Inflammation may be severe, sometimes with fever or chills. Spontaneous rupture occasionally occurs, on the conjunctival side. Differential diagnosis Infections Internal hordeolum. External hordeolum. Orbital or preseptal cellulitis. [patient.info]

• Recurrent Infection

  […] following criteria apply: the chalazion has been present for 3 months without spontaneous resolution AND the chalazion is distressing the patient AND the patient is willing to undergo excision under local anaesthetic OR the chalazion is symptomatic – has recurrent [valeofyorkccg.nhs.uk]

  Incision and curettage of Meibomian cysts will be funded where the following criteria are met: Recurrently Infected Cysts Specialist assessment and treatment of Meibomian cysts will be funded when all three of the following criteria apply: The Meibomian [southwest.devonformularyguidance.nhs.uk]

  Sometimes people are treated with steroid injections in the scenarios of recurrent infections; doctors will also order a biopsy when they occur at regular intervals in order to check the possibility of cancer. [healthresource4u.com]

• Eruptions

  […] develops near meibomian glands or glands of Zeis Probably due to obstruction and nonspecific inflammation (blepharitis), leading to discharge of sebaceous material into surrounding tissue and resulting intense granulomatous inflammatory reaction May erupt [pathologyoutlines.com]

  Spontaneous rupture is rare; however, when it does occur, it usually occurs on the conjunctival side of the eyelid and sometimes erupts through the skin side. Recurrence is common. [msdmanuals.com]

  […] or has not yet erupted. [medical-dictionary.thefreedictionary.com]

• Acne Vulgaris

  Craig G Burkhart and Craig N Burkhart, Similar to acne vulgaris, bacteria may produce the biological glue that causes plugging of the meibomian gland leading to chalazions, Clinical & Experimental Ophthalmology, 36, 3, (295-295), (2008). [dx.doi.org]

  […] agminata Acne vulgaris tends to spare eyelids. [dermnetnz.org]

• Flushing

  The eye can be bathed and flushed once to twice per day with a salt solution made using the following method: Boil water Put 1 teaspoon of ordinary table salt in a clean cup Add 250ml of boiling water and stir to dissolve Allow to cool to room temperature [childrens.health.qld.gov.au]

  The lower eyelid is usually pressed flush against the eye and keeps the eye bathed in lubricating tears. When the eyelid sags away, so do the tears, and the eye can become severely dry. [richmondeye.com]

• Blepharitis

  Blepharitis and lid cysts are more common in fair skinned Scandinavian and Caucasian individuals, and can occur at any age. Patients cite numerous factors as contributing to blepharitis and cyst formation. [bopss.co.uk]

  If you suffer from chronic blepharitis, you are at risk for developing both styes and chalazia. [kadrmaseyecare.com]

  Causes of a Chalazion or Meibomian Cyst Blepharitis – chronic red inflamed lid margins. Acne Rosacea. Seborrheic dermatitis. Lid injections. Symptoms Initially resembles a stye when the gland blocks, then becomes a painless firm lump in the eyelid. [rotoruaeyes.co.nz]

  Associated diseases[5] Blepharitis Acne rosacea Seborrhoeic dermatitis Management Chalazion Chalazia can resolve spontaneously. [patient.info]

• Blurred Vision

  If the chalazion persists causing blurred vision, then they can be removed surgically under local anaesthetic. For more information please visit the links below http://www.aao.org American Academy of Ophthalmology [rotoruaeyes.co.nz]

  A large chalazion may indent the cornea, resulting in slightly blurred vision. [patient.info]

  Blurred vision may be encountered with larger meibomian cysts, while pain is almost always absent. [symptoma.com]

  A larger chalazion may also cause blurred vision by distorting the shape of the eye. Occasionally, a chalazion can cause the entire eyelid to swell suddenly. Treatment It is important not to squeeze or try to "pop" a chalazion or stye. [wespecialeyes.com]

• Foreign Body Sensation

  Consider a routine referral to the Eye Unit if[3]: The chalazion is causing visual or other problems (eg, foreign body sensation). [patient.info]

  The eye may water, become sensitive to bright light, and feel as though something is in it (foreign body sensation). Usually, only a small area of the eyelid is swollen, but sometimes the entire eyelid swells. [msdmanuals.com]

  Some patients complain of a foreign body sensation under the eyelids, and some have watery eyes. The eyelashes can also develop flakes that look like dandruff. All these problems can lead to blurry vision. [asoprs.org]

• Photophobia

  There may be tearing, photophobia, and a foreign body sensation. Typically, a small yellowish pustule develops at the base of an eyelash, surrounded by hyperemia, induration, and diffuse edema. [msdmanuals.com]

  […] urgent GP appointment or go to A&E if: your swollen eyelid is red, hot, painful, tender or blistered your eyelid droops suddenly the pain is in your eye (not your eyelid) the white of your eye is very red, in part or all over you're sensitive to light (photophobia [nhs.uk]

• Redness of Eye

  If the glands are not functioning 100%, the lid margin is typically red, the eyes get irritated and dry (gritty, burny), there is watering, vision can be variable (due to butter-like grease in the tears rather than smooth thin oil) and occasionally they [healthnavigator.org.nz]

  Related: How to get rid of red bloodshot eyes naturally [belmarrahealth.com]

  After the operation The eye will be swollen, red, watery and sticky and, sometimes, there will be bruising or a black eye. This could take several weeks to recover. There might be mild blurring of the vision and bloodstained tears for a few days. [netmums.com]

• Confusion

  Both chalazia and styes are small bumps on our eyelids, and are sometimes confused with each other. Styes are caused by an inflammation or infection in the eyelash follicles or oil glands at the base of the eye lashes. [kadrmaseyecare.com]

  It is quite common for a chalazion to be confused with a stye, which also appears as a lump on the eyelid. There are some differences between the two, however. [belmarrahealth.com]

  Chalazion A sty is sometimes confused with a chalazion (see below), which is a cyst or a specific type of scarring due to chronic inflammation arising in the meibomian glands of the eyelid. [medicinenet.com]

  A chalazion is often confused with a stye (or hordeolum), which is an infection of an oil gland in the eyelid. [aoa.org]

With a properly conducted physical examination and a meticulously obtained patient history, the initial diagnosis of a meibomian cyst can be easily made. The typical appearance of a lump on the eyelid without the presence of pain (mainly seen when a stye develops) is a hallmark of this clinical entity. Some patients report ineffective use of topical antimicrobials [1], which points to a non-infectious type of inflammation. Although the physician can clearly visualize the lesion and make a solid diagnosis based on physical findings only [1], some authors recommend further evaluation of the lump through histopathological methods [2] [3] [6]. The primary reason is that several tumors, particularly sebaceous cell carcinoma (carrying a mortality rate of 20% in the absence of an early diagnosis and up to 50% when tumor spreading occurs) have an identical clinical presentation [2] [3] [5]. Disruption of the skin and ulceration are suggested as signs indicative of a malignancy instead of a meibomian cyst [1], but they may not always be present. The identification of a lipogranulomatous content and multinucleated giant cells with an abundant white blood cell infiltrate are main findings on microscopy of meibomian cysts [6]. Noninvasive meibography, designed to evaluate the morphology of the meibomian glands, is a potentially useful procedure to discriminate between a chalazion and a sebaceous cell carcinoma [5].

This treatment is less invasive than I&D but because of the risk of vision loss, is not preferred treatment choice at the University of Iowa. [webeye.ophth.uiowa.edu]

Surgical removal: If a stye or chalazion does not respond to other treatments, your doctor may surgically drain it. This would be done on an outpatient basis in the office. Both styes and chalazia normally respond well to treatment. [kadrmaseyecare.com]

Prognosis Up to 50% of chalazia resolve (spontaneously or with conservative treatment) but it is not uncommon for them to recur[3, 7]. [patient.info]

A chalazion will often go away without treatment in a month or so. The first treatment is to place warm compresses over the eyelid for 10 to 15 minutes at least four times a day. [medlineplus.gov]

Treatment Blepharitis is a chronic condition for which there is no cure and requires longterm treatment to keep it under control. [murdocheye.com.au]

The prognosis of Chalazion is usually excellent with adequate treatment Please find comprehensive information on Chalazion regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis [dovemed.com]

What is the prognosis of a chalazion? In general, a chalazion does not affect sight. Rarely, the lump itself is large enough to distort the ocular surface and cause some temporary astigmatism with blurring of the vision. [medicinenet.com]

A chalazion is usually a self-limiting condition with excellent prognosis. However, the patient is instructed to follow regular lid hygiene measures and control of meibomitis. Prognosis Prognosis is excellent. Jerry A. Shields, Carol L. Shields. [emedicine.medscape.com]

Prognosis Up to 50% of chalazia resolve (spontaneously or with conservative treatment) but it is not uncommon for them to recur[3, 7]. [patient.info]

However, there may be times when an associated infectious etiology is suspected. If an infection is considered, tetracyclines are the antibiotics of choice. [ncbi.nlm.nih.gov]

Chalazion Definition: Firm, nontender nodular lesion of the eyelid resulting from obstruction and subsequent chronic granulomatous inflammation of a Zeis or meibomian gland. http://dro.hs.columbia.edu/chalazion.htm Etiology: Normally, sebaceous meibomian [pedclerk.bsd.uchicago.edu]

Etiology Chalazia occur after gland blockage, which can be associated with the following: Poor lid hygiene (the precise causal role has not yet been established) Acne rosacea High blood lipid concentrations (possible risk from increased blockage of sebaceous [emedicine.medscape.com]

Epidemiology[1, 4] Chalazia are the most common of all lid lumps. They can occur at any age. [patient.info]

Key points Description Benign granuloma of oil-producing gland of the eyelid Cause Blockage of gland duct by thick oil or keratin causes gland rupture and lid inflammation Epidemiology Common lid lesion associated with blepharitis at any age Clinical [pulsetoday.co.uk]

Meanwhile, recent epidemiological survey showed MGD is a major cause of dry eye. In the MGD clinic, we thoroughly examine both subjective symptoms and objective findings for accurate diagnosis. [ophthal.med.keio.ac.jp]

Epidemiology United States and international statistics Chalazia are common, but their exact incidence and prevalence in the United States are not known. Data about the worldwide prevalence or incidence of chalazia are also unavailable. [emedicine.medscape.com]

Pathophysiology Chalazia form when lipid breakdown products, possibly from bacterial enzymes or retained sebaceous secretions, leak into surrounding tissue and incite a granulomatous inflammatory response. [2]. [emedicine.medscape.com]

In people with seborrhea of the lids and recurrent chalazia, warm compresses and careful cleansing of the lid margins can be helpful for prevention. [medicinenet.com]

How to prevent chalazion cysts The best way to prevent the development of chalazion cysts is to keep your eyelids clean and free of irritants. Wash your hands often to prevent dirt from being transferred to your eyelid when you rub your eyes. [belmarrahealth.com]

Prevention Cleansing the eye area every day can help prevent a chalazion from developing or recurring. Using eyelid scrubs or premoistened cleansing wipes to keep the oil glands from becoming blocked. [medicalnewstoday.com]

1. Arbabi EM, Kelly RJ, Carrim ZI. Chalazion. BMJ. 2010;341:c4044.
2. Ozdal PC, Codère F, Callejo S, Caissie AL, Burnier MN. Accuracy of the clinical diagnosis of chalazion. Eye (Lond). 2004;18(2):135-138.
3. Al-Mujaini A, Sabt B, Al-Hadabi I. It is not chalazion. Oman J Ophthalmol. 2013;6(1):63-69.
4. Gilchrist H, Lee G. Management of chalazia in general practice. Aust Fam Physician. 2009 May;38(5):311-314.
5. Nemoto Y, Arita R, Mizota A, Sasajima Y. Differentiation between chalazion and sebaceous carcinoma by noninvasive meibography. Clin Ophthalmol. 2014;8:1869-1875.
6. Ahuja S, Rao VA, Kumar P, Rajesh N, Srinivasan R. Sebaceoma of the Conjunctiva Presenting as a Chalazion. Indian J Dermatol. 2014;59(5):521-522.