Chalazion
Background
- Chronic inflammatory lesion due to blockage of Zeis or meibomian tear gland
- Also known as meibomian gland lipogranuloma
- Often results from healing hordeolum
Clinical Features
- Eyelid swelling and erythema that evolve into a painless, rubbery, nodular lesion
- More commonly seen on upper eyelid where density of Meibomian glands is greatest
Differential Diagnosis
Periorbital swelling
Proptosis
- Normal IOP
- Orbital cellulitis
- Orbital pseudotumor
- Orbital tumor
- Increased IOP
- Retrobulbar abscess
- Retrobulbar emphysema
- Retrobulbar hemorrhage
- Ocular compartment syndrome
- Orbital tumor
No proptosis
- Periorbital cellulitis/erysipelas
- Dacryocystitis (lacrimal duct)
- Dacryocele/Dacryocystocele
- Dacryostenosis
- Dacryoadenitis (lacrimal gland)
- Allergic reaction
- Nephrotic Syndrome (pediatrics)
Lid Complications
- Blepharitis (crusts)
- Chalazion (meibomian gland)
- Stye (hordeolum) (eyelash folicle)
Other
- Subperiosteal abscess
- Orbital abscess
- Cavernous sinus thrombosis
- Conjunctivitis
- Contact dermatitis
- Herpes zoster
- Herpes simplex
- Sarcoidosis
- Granulomatosis with polyangiitis
Management
- Hot compresses x15min QID
- Antibiotics not indicated: this is a granulomatous condition
- Most resolve without intervention in weeks-months
Disposition
- Refer to ophthalmology if persistent or recurring