Can long-standing chalazia be treated without an incision? (photo)

Hi there!

I'm sorry that your chalazion has lasted for so long!

There are some conservative measures that you can take to see if the chalazion resolves on its own - lid hygiene, warm compress, and antibiotic ointment.

I usually ask my patients to perform lid hygiene. Purchase some cotton squares (that are used for makeup removal), fold a square twice and dip the blunt edge into a mixture of baby shampoo (that doesn't irritate your eye) and warm water. Stand in front of the mirror, pull up your upper lid slightly, and give the area behind the eye lash (where the opening of the oil glands are) a gentle scrub.

Additionally, use a clean, hot towel (be careful not to burn your skin), and apply warm compress to the lump. These measures, together with an antibiotic ointment, may lead to resolution of your chalazion. Regular lid hygiene is important to prevent a recurrence of chalazia!

If these measures fail, and/or if the lump becomes bigger, redder, or more painful, do see an ophthalmologist and get it drained by a small cut.

Hope your chalazion resolves and get well soon!

Conservative treatment options including warm compresses and topical anti-inflammatories, as well as intralesional triamcinolone are thought to be effective options.

Intralesional Triamcinolone is an effective treatment option for primary chalazia that is uncomplicated, and where diagnosis is not in doubt. It is probably as efficacious as incision / curettage (approximately 80-90% resolution) for primary (first occurrence chalazia) which is uncomplicated and where the risk of other pathology is low.

However, up to a third of patients require multiple injections, and the time to resolution is likely longer (reportedly between 5 - 20 days) than an incision / curettage. In addition, long-term side-effects of white deposits (triamcinolone particles) in the skin, skin hypopigmentation / depigmentation are also possible.

Less likely are steroid-related complications in the eye including raised intraocular pressure or cataract formation. However, chronic lesions which are organised are best suited for surgical removal either through an incision / curettage or in recurrent cases may also require excision biopsy. You should discuss specific options with your treating ophthalmologist!