Chalazion
Chalazion is a chronic sterile inflammation of the eyelid resulting from a
lipogranuloma of the meibomian glands that line the posterior margins of the
eyelids (see Fig. 29-7). It is deeper in the eyelid tis
...
Chalazion
Chalazion is a chronic sterile inflammation of the eyelid resulting from a
lipogranuloma of the meibomian glands that line the posterior margins of the
eyelids (see Fig. 29-7). It is deeper in the eyelid tissue than a hordeolum and
may result from an internal hordeolum or retained lipid granular secretions.
Clinical Findings
Initially, mild erythema and slight swelling of the involved eyelid are seen.
After a few days the inflammation resolves, and a slow growing, round,
nonpigmented, painless (key finding) mass remains. It may persist for a long
time and is a commonly acquired lid lesion seen in children (see Fig. 29-7).
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Management
• Acute lesions are treated with hot compresses.
• Refer to an ophthalmologist for surgical incision or topical intralesional
corticosteroid injections if the condition is unresolved or if the lesion
causes cosmetic concerns. A chalazion can distort vision by causing
astigmatism as a result of pressure on the orbit.
Complications
Recurrence is common. Fragile, vascular granulation tissue called pyogenic
granuloma that enlarges and bleeds rapidly can occur if a chalazion breaks
through the conjunctival surface.
Types of Conjunctivitis
Type Incidence/Etiology
Clinical
Finding
s
Diagnosis Management*
Ophthalmi
a
neonat
orum
Neonates: Chlamydia
trachomatis,
Staphylococcus aureus,
Neisseria
gonorrhoeae, HSV
(silver nitrate reaction
occurs in 10% of
neonates)
Erythema,
chemo
sis,
purule
nt
exudat
e
with N
Culture (ELISA,
PCR), Gram
stain, R/O N.
gonorrhoeae,
chlamydia
Saline irrigation to
eyes until
exudate gone;
follow with
erythromycin
ointment
For N.
gonorrhoeae:ceft
riaxone or IM or
IV
1
Type Incidence/Etiology
Clinical
Finding
s
Diagnosis Management*
.
gonorr
hoeae;
clear
to
mucoi
d
exudat
e with
chlamy
dia
For chlamydia:
erythromycin or
possibly
azithromycin PO
For HSV: ant
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