A meibomian cyst, commonly referred to as chalazion, is a non-infectious inflammatory disease of the sebaceous glands on the eyelids that presents as an enlarging lump over the course of days or weeks without resolution to topical antimicrobial therapy. Acne rosacea and seborrheic dermatitis increase the risk for meibomian cysts. Blurred vision may be encountered with larger meibomian cysts, while pain is almost always absent. The diagnosis rests on clinical criteria, but because malignant tumors may have an identical clinical presentation, a histopathological examination is advocated.
Presentation
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].
Eyes
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Blepharitis
Blepharitis Blepharitis means inflammation of the eyelids. Blepharitis can be a troublesome and recurring condition with no one-off cure. [evidence.nhs.uk]
Preferred Name meibomian cyst Synonyms Chalazion meibomian gland lipogranuloma Definitions A blepharitis that is characterized as a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. [bioportal.bioontology.org]
Aetiology Blockage of Meibomian gland duct with retention and stagnation of secretion May occur spontaneously or follow an acute hordeolum (internal) Predisposing factors Chronic blepharitis Rosacea Seborrhoeic dermatitis Pregnancy Diabetes mellitus Symptoms [college-optometrists.org]
From Wikidata Jump to navigation Jump to search blepharitis that is characterized as a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid Chalazion meibomian gland lipogranuloma Meibomian Cyst Cyst [wikidata.org]
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Red Eye
Possible problems include: · Swelling and bruising are temporary, but in some patients can take longer than normal to recover · The cyst might not disappear or could regrow after the operation · Allergy to the drops or ointment causing a sore red eye [netmums.com]
If any of the following signs of infection occur, please seek medical advice immediately: Swelling of the skin around the chalazion Redness or discolouration of the area Warmth and tenderness of affected area Fever Acutely sticky, red eye with severe [childrens.health.qld.gov.au]
Symptoms include watering of the eye, redness, eye irritation, crusting discharge. Entropion is the inward turning of either lower or upper eyelid, resulting in the eye lashes rubbing against the eye causing pain, redness and irritation. [murdocheye.com.au]
There are separate CKS topics on Blepharitis, Conjunctivitis - allergic, Corneal superficial injury, Dry eye syndrome, Giant cell arteritis, Herpes simplex - ocular, Red eye, and Uveitis. [evidence.nhs.uk]
Workup
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].
Microbiology
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Microsporum
Giant Chalazion. 61 Lloyd M...Wasserman BN 30454715 2018 28 A case report of eyelid Merkel cell carcinoma occurring under treatment with nivolumab for a lung adenocarcinoma. 61 Lavacchi D...Mini E 30348121 2018 29 Eyelid tinea with blepharitis due to Microsporum [malacards.org]
Treatment
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]
If you are considering Chalazion treatment you can see our prices for treatment and consultation. Read more about Chalazion treatment. [clinicalondon.co.uk]
A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses. Clin Experiment Ophthalmol 2007;35:706-12 [pulsetoday.co.uk]
Initial Treatment Initial treatment should include: massage through a hot flannel for 30 seconds first thing (at least twice a day) in the morning and last thing at night and any other times that are possible. [valeofyorkccg.nhs.uk]
Prognosis
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]
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]
Etiology
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]
Etiology: Normally, sebaceous meibomian glands of the eyelid produce an oily substance (meibum) that forms the hydrophobic lipid layer of the tear film. [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
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]
Epidemiology [ 1, 4 ] Chalazia are the most common of all lid lumps. They can occur at any age. [patient.info]
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
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]
Prevention
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]
The meibomian gland (also known as the tarsal gland) supplies oil or sebum that prevents the eye film from drying-up While some Chalazia may be tiny, most may often be visible as lumps on the eyelid. [dovemed.com]
The oily film prevents the tears from evaporating, therefore allowing the eyes to remain moisturized. Apart from lubrication, the oil also helps prevent the severe disorder known as dry eyes in which there is impairment of vision. [home-remedies-for-you.com]
[…] understand that you are thoroughly tired of battling with this condition but it seems as if your doctors have been doing everything according to the book to treat this and if you keep on getting repeated infections, you may need to use tetracyclines preventatively [health24.com]
References
- Arbabi EM, Kelly RJ, Carrim ZI. Chalazion. BMJ. 2010;341:c4044.
- Ozdal PC, Codère F, Callejo S, Caissie AL, Burnier MN. Accuracy of the clinical diagnosis of chalazion. Eye (Lond). 2004;18(2):135-138.
- Al-Mujaini A, Sabt B, Al-Hadabi I. It is not chalazion. Oman J Ophthalmol. 2013;6(1):63-69.
- Gilchrist H, Lee G. Management of chalazia in general practice. Aust Fam Physician. 2009 May;38(5):311-314.
- Nemoto Y, Arita R, Mizota A, Sasajima Y. Differentiation between chalazion and sebaceous carcinoma by noninvasive meibography. Clin Ophthalmol. 2014;8:1869-1875.
- 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.