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Meibomian cyst (chalazion) (Risk factors (Seberrhoic dermatitis, Acne…
Meibomian cyst
(chalazion)
Definition
Sterile, inflammatory granuloma
caused by blocked sebaceous gland
Epidemiology
All ages
Commonest cause of lid lump
Pathophysiology
Anatomy
Meibomian glands located in the tarsal plate,
along the eyelid margin
Produce lipid secretion (lipid layer of tear film)
Mechanism
Gland obstruction causes enlargement and rupture of lipid
contents into eyelid soft tissue
Causes inflammation and granuloma formation, which
subsides with time to become painless
Can occur acutely or over time
May drain spontaneously or persist as a nodule
Risk factors
Seberrhoic dermatitis
Acne rosacea
Chronic blepharitis
Clinical
presentation
Eyelid lump
Insidious onset, initial discomfort
then settles, firm non-tender
Diagnosis
Examination
External eye examination
Lump on upper/lower lid, non-erythematous,
non-tender, hard, smooth, immobile, yellowish (lipogranuloma),
not adherent to the skin (adhered to tarsal plate),
no ulceration, discharge, bleeding etc.
History
DH
Current meds, eye drops, allergies
FH
Eye/skin conditions
PMH
Blepharitis, seberrhoic dermatitis,
acne rosacea
SH
Occupation, alcohol, smoking
PC/HPC
Eyelid lump, insidious onset,
initially tender and swollen then non-tender,
no red flags, usually unilateral
Management
Conservative
Information and advice
Manage risk factors
Hot compresses (5-10m, 2x/d) to aid drainage
Ophthalomolgy referral if not resolving and causing issues
Surgical
I+D
Indication: not resolving, complications
MOA: I+S under LA
Complications
Periorbital/orbital cellulitis
Rare
Visual problems
Astigmatism, visual disturbance, ptosis
If very large
Prognosis
Most (80%) resolve spontaneously
in weeks-months
Can get recurrence if risk factors