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STYE AND CHALAZION



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STYE AND CHALAZIon





Jorge A . Montes, MD, FACS



Untreated blepharitis has many consequences, from dry eyes, pain, blurry vision, ocular surface inflammation, and redness. Possibly the most uncomfortable and unsightly is the formation of styles and chalazion. What are they and how do they form? It's worth discussing these two conditions separately, but first some anatomy.


ANATOMY

A close inspection of the eyelid shows a clear separation between the eyelashes and the meibomian glands' oil-secreting glands.


Styes will form when the eyelash follicle becomes infected, and chalazia develop when the oil-secreting glands become infected.



Cross-section of an eyelid



STYE

Styes are uncomfortable and grow fast. A stye will form when there is an infected eyelash follicle; therefore, they remain located at the eyelid margin. Eye rubbing tends to be a common cause of styes, yet many medical reasons may predispose people to get them.


Treatment

Styes usually improve with a warm compress and eyelid cleansing. It may be necessary to start a topical antibiotic or antibiotic/steroid medication.



CHALAZION

Inflammation of the eyelid margin can narrow the opening of the meibomian glands. Furthermore, the consistency of the oil produced by the glands becomes viscous and turbid, and flow through the gland becomes limited.


The oil itself is pro-inflammatory, and as oil accumulates, it causes surrounding tissue to become irritated, painful, and inflamed.


Early on, chalazia may present like preseptal cellulitis, an infection in the eyelid skin. After your immune system has had an opportunity to loculate the oil, a bump will start to form. If untreated, the oil-filled cyst can persist for months.



Chalazion stages



Treatment

Warm compresses and eyelid cleansing help clean the glands' surface, lower bacterial load along the eyelid margin, and increase flow through the gland. Topical antibiotics further help decrease bacterial load, while topical steroids reduce inflammation. A step-wise approach is taken based on the presenting exam as every patient is different.


When medical therapy fails, or if the chalazion is large, surgical excision is an excellent option.



eyelid hygeine shampoo and wipes



eyelid cleansers



warm compress masks



PROGNOSIS

Styes have an excellent prognosis as long as there is an effort to make lifestyle changes that include keeping a strict eyelid hygiene regimen.


Chalazia also have an excellent prognosis, although they can take weeks to months before resolving. They can also cause ocular surface dryness as every chalazion can leave the involved gland inactive.


PRESERVATION

Lipiflow®, when performed yearly, can help preserve the function of the meibomian glands but cannot restore the function of glands already lost. It works by warming up the meibomian glands to just the right temperature while also expressing the gland's contents.





DHR Health Eye Institute



4500 North 10th Street, Suite 100, McAllen, TX 78504
Phone: 956-362-2070
Fax: 956-362-2074