Southwest, FL | Case of the Day- Lump on Eyelid | Cataract & Refractive Institute of Florida

Dr. Croley: Hello, and welcome to Case of the Day. I'm Dr. Croley, and today we're going to discuss a case where a gentleman, young man, came in today complaining that he had a bump or lump on his upper lid. It'd been there for approximately a month, and it wasn't really changing in size, so he wasn't that concerned about it, and it was only minimally tender to touch. And so when we examined him he had what we call a chalazion. A chalazion is a cyst that forms in the meibomian glands in your eyelids. So you have a set of glands on the upper and lower lid that secrete the lipid layer, or the outer oily layer of your tear film, and sometimes they get plugged up and form a cyst. The cysts are usually not infected, but they can be, in some cases, and people can have an infection inside the gland.

Dr. Croley: Something that's similar, but not exactly the same, is called a stye, or hordeolum. And that is a little different in that it is an infection in a sebaceous gland in your lid. And that is an infection, which is different from a chalazion, which may not be an infection; it's just a cyst. So they're treated similarly and they look very similar, so it's really a matter of medical terminology, because you really sort of do the same thing for both. There are occasions where people get chalazions where they do get bigger and bigger and bigger and become painful, but a lot of times, they happen, and they form sort of a little hard nodule in the lid, and they may stay there for an extended period of time.

Dr. Croley: The treatment when someone initially comes in is that you tell them they can try hot compresses. So we tell people to take a wash cloth, put in hot water, as hot as you can stand without burning yourself, and you apply the compress to your eye. When it cools off, you put it back in the hot water, and then put it back to your eye and keep your lid heated up for about 15 minutes. And if you can do that four times a day, that'd be great. And many times that alone will take care of the chalazion. It will resolve and go away, especially if someone starts doing that early in the process. If it will not go away and it forms this nodule and it is something the patient doesn't want, or it is painful, they can occasionally cause blurred vision. That is, the bump that's on the upper lid is rubbing across- when you blink, it rubs across your cornea and can distort your cornea and actually blur your vision. So sometimes they're removed because they're blurring a person's vision.

Dr. Croley: But if it's not going to go away, then we go ahead and operate and clean or remove the cyst. And how do we do that? So we take an injection of local anesthetic and put it into the eyelid. That's the bad part of the procedure. And then we have a little clamp that we put on the lid, and we actually flip the lid inside out and we make the incision on the inside of the eyelid. So the incision is not on the outside of the lid, but actually on the inside of the lid. So we open up the cyst and then we clean out the mucus, and could be puss-like material, out of the cyst. We have a little curat that has fine little teeth, and we clean out that cyst area, because if you don't do that, the cystic wall, if it remains, could form a cyst again. So we have to scrape and clean it out and get it clean. And then we put people on, typically, an antibiotic eye drop for a week to 10 days, and have them continue hot compresses after the procedure. And better than 90% of the time, that procedure will get rid of the chalazion.

Dr. Croley: So chalazions are very common. People tend to get them when they're- a lot of children get them, young people get them, and then it sort of, through middle age, we don't see that quite as much. And then as people get older, they sort of return sometimes. Some people get them again. It's sometimes associated with a disease called blepharitis, which is an infection or inflammation around the eyelashes, and that's exactly where those little meibomian glands open. So if someone has chronic blepharitis of their eyelids, they typically have a lot more chalazions developed. And so it's important, if you have blepharitis, to keep your lids clean and to keep the blepharitis under control.

Dr. Croley: So if you have any questions about a lump on somebody's lid, or a chalazion, you can always contact us through the website. I'll be happy to answer any questions. If not, may God bless you with healthy eyes and great vision.