How Does a Chalazion Look?
An Eyelid Bump That's Not a Sty
Medically reviewed by Andrew Greenberg, MD
A chalazion is a swollen, pain-free lump on the eyelid. It gradually forms when the meibomian gland, a sebaceous (oil) gland, is blocked. A chalazion is sometimes called an eyelid cyst or a meibomian cyst.
A chalazion might be painful at first, but the pain will subside quickly. Most chalazia (the plural of chalazion) form on the underside of the upper eyelid. While rare, they can sometimes form on the lower eyelid. Chalazia can affect anyone regardless of age, although they are less common in children than adults.
They are benign (harmless) bumps that are not cancerous. A chalazion can often be treated at home. However, you're encouraged to see a healthcare provider, such as an eye specialist, for diagnosis and treatment if it lasts longer than a couple weeks.
This article will explain the differences and similarities between a chalazion and a sty, what causes a chalazion to develop, treatment, removal, and more.
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Chalazion: A Cyst, Bump, or Sty?
It can sometimes be difficult to tell the difference between a chalazion and a sty. Both look like bumps or cysts, but they are different.
Interestingly, if a sty is not adequately treated, it may become a chalazion. This is because the sty can prevent the eyelid's oil glands from draining.
Related: Bump on the Eyelid
Similarities
Chalazia and sties can look very similar. Both can cause tenderness, redness, and swelling, but sties are more painful.
Your healthcare provider can diagnose a chalazion or sty by physically examining the eyelid and asking you about symptoms. If there is little or no tenderness, swelling, or redness around the eyelid, you will likely be diagnosed with a chalazion.
But if there is pain, tenderness, swelling, or burning, they might diagnose the eyelid bump as a sty.
While the causes of chalazia and sties are very different, both can start in the meibomian gland of the eyelid. The other location a sty can develop is in an eyelash hair follicle.
Sometimes, these bumps go away without treatment. Self-care measures, such as warm compresses, can help speed up the healing process. If self-care methods don't work, your healthcare provider can offer medicinal treatments or surgery.
Related: How to Get Rid of a Stye
Differences
A chalazion is not typically painful and does not always cause swelling. On the other hand, a sty is very painful. Since it is related to an infection, it can cause swelling in the entire eyelid.
Additional symptoms of a sty include:
Eye crustiness
Feeling that there is something in the eye
A scratchy feeling in the eye
Tearing of the affected eye
Bacterial infections are often the cause of sties. According to the American Academy of Ophthalmology, the infection starts due to bacteria in an eyelash hair follicle or a meibomian gland of the eyelid.
Related: Chalazion vs. Stye: What Are the Differences?
What Makes a Chalazion Go Away?
A chalazion can sometimes resolve without treatment. According to a 2023 Scientific Reports article, in about 25% to 50% of cases, a chalazion will be self-limiting, meaning it will resolve (with or without treatment) in about one to three months.
Self-care and at-home therapies can help soften the oil blockage. When the blockage is reduced, the chalazion will shrink until it is completely gone.
One way to reduce the chalazion's size is with warm compresses. You can start by soaking a clean washcloth in hot water and allow it to cool down. Once the water is at a comfortable temperature for the eyelid, apply the washcloth to the eyelid and hold it there for 10 to 15 minutes. Repeat three to five times a day.
Massage can also help clear the gland. Massage the affected eye area with a clean finger.
In addition, consider an over-the-counter (OTC) treatment. Eyewashes and eyelid wipes can help keep the affected area clean and reduce oil blockage in the chalazion.
If a chalazion does not improve with home treatment, contact a healthcare provider. They can prescribe antibiotic eye drops or an eye ointment to manage pain or other symptoms.
If the chalazion does not go away on its own, your healthcare provider may recommend a steroid injection or surgery to treat it. A steroid injection can reduce inflammation and swelling, while surgery can drain the chalazion to help it heal.
In many cases, a chalazion will disappear as it heals, but this takes time. Left untreated, a chalazion could become infected, leading to discomfort or affecting vision. If your chalazion does not heal within a few weeks, consult a healthcare provider.
Do Not Pop a Chalazion
You should let a chalazion heal naturally. Do not attempt to pop or squeeze it. To reduce the risk of infection, you should also avoid wearing eye makeup or contact lenses while the eyelid is healing.
Chalazia typically do not need antibiotic treatment. But if the chalazion becomes infected, you may need an antibiotic ointment or an oral antibiotic.
Various antibiotics are available to treat an infected chalazion that your primary care provider or an ophthalmologist can prescribe. An ophthalmologist is a medical doctor who diagnoses and treats eye diseases, performs eye surgery, and prescribes eyeglasses and contact lenses to correct vision problems.
Related: Optometrist vs. Ophthalmologist: What’s the Difference?
What Makes Chalazion Appear?
Your meibomian glands are located within the eyelids, near the eyelashes. They produce an oily lubricant that prevents the drying of the tear film, the thin layer of tears covering the cornea (the outer surface of the eye). A chalazion may form if the oil inside a meibomian gland starts to thicken.
Chalazia are sometimes a complication of an inflammatory condition. Such conditions include:
Seborrheic dermatitis: A skin condition that mainly affects the scalp but also may cause oily areas on the face, eyebrows, eyelids, nose, and ears
Acne rosacea: A skin disease that causes the face to flush and acne-like bumps on various parts of the face and sometimes affects the eyes, causing inflamed or swollen eyelids, swelling around the eyes, and itchy, dry eyes
Chronic blepharitis: A disease of the eyelids that causes redness, thickening, or flaky crusting along the eyelids and eyelashes
Chalazia might also be associated with viral conjunctivitis and can lead to follicular conjunctivitis. Conjunctivitis is often referred to as pink eye.
Follicular conjunctivitis is the inflammation of the conjunctiva (the fine, transparent layer of the eye). Symptoms include:
Reddish-pink eye appearance
Fluid buildup
Swelling
Watery discharge
Light sensitivity
Eye pain
How to Remove a Chalazion
You may need surgery to remove a chalazion if it does not go away in a few weeks or if it blocks your vision. You may also consider surgery if the chalazion is large, you have more than one chalazion on the same eyelid, or you feel like the bumps on your eyelid affect your appearance.
Surgery to remove a chalazion is an incision and curettage procedure. It takes place in an eye clinic or the office of your ophthalmologist.
The incision and curettage procedure starts with the healthcare provider numbing the skin around the affected eye. This is either done with anesthetic drops in the eye or an injection in the eyelid.
A lid clamp will hold the eyelid in place and allow the healthcare provider to make a cut on the inside of the eyelid. The provider will then drain the contents of the chalazion. Once complete, the eye clamp is removed, and an antibiotic ointment and an eye patch are applied to prevent infection.
Chalazion surgery requires no stitches. The eyelid may feel sore, and there may be some bruising. To prevent infection, you will need to keep the eye covered for at least one week. Your healthcare provider will also prescribe antibiotic creams and eye drops.
Your eyelid should be fully healed and back to its normal appearance within two weeks after surgery. Stitches will dissolve on their own and will not need to be removed by a healthcare provider.
The surgery to remove a chalazion is generally safe, but risks are possible and may include:
Allergy or sensitivity to anesthesia
General surgical risks like bleeding, bruising, and infection
Recurrence of the chalazion or development of a new one
Eyelid dimpling
Permanent loss of eyelashes
Trichiasis (abnormal eyelash growth)
Eye injury
Scarring of the eyelid
Related: Chalazion Surgery: Everything You Need to Know
Chronic Chalazion and Minimizing Recurrence
While rare, chalazia can recur. This typically is the case when there is chronic inflammation in the eyelid. Chronic blepharitis, seborrheic dermatitis, and acne rosacea can also lead to chronic chalazia.
While there is no way to prevent chalazia, you can reduce your risk by keeping your eyelids clean. Ways to keep the eyelids clean and potentially prevent future chalazia are:
Wash hands often, especially before handling contact lenses and touching the eyes.
If contacts are disposable, make sure you wear them only for the recommended amount of time.
Always clean contact lenses with a disinfecting lens solution.
Remove eye makeup before going to bed.
Replace eye makeup every few months, and don't share your makeup.
Check with your healthcare provider regarding whether it is safe to scrub your eyelids, especially if you have had a chalazion in the past.
If approved by a healthcare provider, use supplemental oral omega-3 or flaxseed oil to reduce inflammation of the eyelids.
Should you experience recurrent chalazia, you will want to be under the care of an ophthalmologist.
When to Consult a Healthcare Provider
If a chalazion does not go away with at-home treatment, contact an eye specialist or an ophthalmologist. An ophthalmologist can check your eyelid and confirm whether you have a chalazion or another eyelid bump, such as a sty. They can also recommend treatments, including draining and removing the chalazion surgically.
Additional reasons to reach out to an ophthalmologist for a chalazion include if the chalazion:
Gets bigger
Becomes painful
Affects or blocks your vision
Appears infected
Signs of an infection are:
Eye redness
Crusty debris along the eyelids
Burning
Itching
Swelling
Watery eyes
Light sensitivity
You should also contact your ophthalmologist if the chalazion goes away and then returns. Your provider can prescribe treatments to manage symptoms, reduce inflammation in the eyelid, and manage any inflammatory conditions that may be contributing to recurrences.
Related: Types of Eye Doctor Specialists
Summary
A chalazion is a small, firm bump on the eyelid. It generally does not cause pain. It is caused by a blockage of the tiny oil glands that keep the eyes moist. Some people are at an increased risk for chalazia because of certain skin and eye conditions like seborrheic dermatitis, acne rosacea, and chronic blepharitis.
Chalazia can look like sties, but sties are the result of a bacterial infection and can cause severe pain. Symptoms of chalazion are mild irritation when the chalazion first develops, blurred vision if the chalazion is large, and a swollen eyelid. An untreated sty can become a chalazion.
You should see an ophthalmologist to diagnose and treat a chalazion that does not disappear on its own or with at-home treatments. At-treatments include warm compresses and good hygiene. Do not try to pop the chalazion; it needs to heal on its own.
An ophthalmologist can prescribe a steroid injection to reduce swelling of the eyelid. Drainage surgery may be needed if the chalazion is very large, affects vision, or impacts your physical or emotional health in another way.
Chalazia can recur, especially in people at an increased risk for them. The best way to prevent recurrence is through handwashing, safe contact lens care, face washing, not using old makeup, and not sharing makeup with others.
Read the original article on Verywell Health.
