Chalazion and stye are two very common inflammations of the eyelid glands, for which we visit the ophthalmologist. A timely visit to the specialist and proper treatment will help us avoid pain and possible surgical removal for cosmetic reasons, if they are left untreated for a long time.

What is chalazion?

Chalazion (meibomian gland cyst) is a chronic lipogranulomatous inflammatory damage caused by obstruction of the orifices of the glands and pooling of sebaceous secretions. This gradually creates a cyst usually found in the upper or lower eyelid. Patients with rosacea or seborrhoeic dermatitis face higher risks to present chalazion or even multiple and relapsing chalazia.

What is stye?

Stye can be either internal or external. Internal stye is a small abscess caused by acute staphylococcal infection of the meibomian glands, while external stye is a small acute staphylococcal abscess of an eyelash pocket and of the respective Zeis and Moll glands.

What is the difference between chalazion and stye?

Chalazion is sometimes confused with stye, which also appears as a nubbin on the eyelid. Stye is an acute infection of the eyelash pocket and forms a red, painful nubbin near the edge of the eyelid. Chalazion is usually a reaction to enclosed lipid secretions and is not caused by bacteria, even though its position can be secondarily infected. Chalazia tend to appear away from the edge of the eyelid, contrary to styes that tend to climax towards the inside or nasal part of the eyelid. Sometimes, a chalazion can cause a sudden edema on the entire eyelid.

What are the symptoms from their appearance?

Both appear as inflammatory swellings of the eyelid. The eyelid is edematous, red and in pain, especially under pressure. They can appear on the upper or lower eyelid, in the inside or the outside. If the inflammation is large, then the eyelid tends to close, while the weight of the cyst that has been created in larger chalazia can cause blurry vision due to astigmatism caused by pressure on the cornea. In stye, a white spot may appear, which indicates presence of pus.

How is stye treated?

Internal:

Incision and drainage may be necessary in case there are some remnants after the recession of the acute infection

External:

No treatment is required in the majority of cases, since stye is usually either absorbed automatically or is drained forward near the base of the eyelash.
Warm compressesstrong> may prove useful in severe cases.
The removal of the eyelash connected to the afflicted pocket may accelerate pus drainage.
Systematic antibiotics may be necessary when there is severe eyelid cellulitis.

How is chalazion treated?

When chalazion is small and without symptoms, it can be removed without treatment. If it is large, it may blur vision due to deformation of the shape of the eye. Local ointments and eye drops with antibiotics or mixed use of local cortisone is the main treatment. It is important to start treatment immediately, because if the inflammation becomes chronic, then it can create a full cyst, which cannot be treated with medication, but needs to be surgically removed. So, if chalazion has not passed after 3 or 4 weeks, then surgical removal can be done, mainly for cosmetic reasons.

Therefore, chalazia can be treated with one of the following treatments or with a combination of them:

Antibiotics or combination with steroid local eye drops during the day and ointment at night for a few days.
Warm compresses.
 
Warm compresses can be applied in various ways. The simplest is to hold a clean towel doused in warm water on our closed eyelids for 5-10 minutes, 3-4 times a day. The towel should be doused again to keep warm. Finally, we dry the eyelids using smooth movements and wipe away all signs of pus or other secretions with a clean gauze which changes for every wiping.
Gland massaging smoothly and periodically, in combination with medication and warm compresses.
Surgical removal. When chalazion does not subside with the above treatments, we move on to a surgical procedure which doesn't require staying overnight at the hospital. After using anesthetic eye drops, an anesthetic injection will be done under the skin, next to the cyst, in order for you not to feel any pain. The feeling will be similar to the injection done by a dentist. Subsequently, the surgeon will turn the eyelid and from a small vertical incision he will do on the inside of the eyelid he will remove the contents of the cyst along with part of its walls. Finally, an eye cover that applies pressure is used, which needs to stay on for at leastt six hours. After the removal of the eye cover you can wash your eye with a clean cotton towel or a gauze doused in cool water, which you will have boiled in advance, in order for the eye to be cleaned from any remnants of blood or other secretions. You may notice some bruising on your eye, which, however, will disappear within the next few days. Your doctor will give you antibiotic eye drops or ointment, which you should use at least 4 times a day for at least a week.
Chalazia usually respond well to treatment, even though some people are prone to relapses. In that case, a repeated treatment is required, as well as a thorough examination that will show the causes of the relapses. If a chalazion appears on the same spot, then the doctor will order a biopsy in order to avoid more severe problems.
Finally, frequent relapses can be avoided with the use of corrective glasses for people who have hyperopia or advanced presbyopia and don't wear glasses.

Advice to prevent reappearance of chalazion

Thorough cleaning of the eyelids prevents reappearance of chalazia in people who are prone to them. By cleaning the eyelid area regularly with baby shampoo we decrease the chances of gland obstruction. Furthermore, adopting some dietary habits, without it being panacea, certainly contributes both to prevention of reappearance of chalazia and to general health improvement. So:

Increase consumption of foods rich in vitamin A. These foods include fish, preferably roasted, like salmon and tuna. It is advisable to consume them about 2-3 times a week. Consumption of B-carotene is necessary since it becomes vitamin A in our body.
Include in your diet foods rich in vitamin B6, such as vegetables (peas and beans), tuna, salmon, chicken, and vitamin B3 (sunflower seeds).
Fresh salads are also a very useful food. Consume three bowls a day.
Drink large quantities of water, at least 6 glasses a day.

Remember:Your ophthalmologist is the best source for responsible answers on issues related to your eyes and their health. Under no circumstances is information taken from our website intended to replace him. Seek your doctor for complete information.

What is blepharitis?

Blepharitis is a common and persistent inflammation of the eyelids and often affects people with oily skin, dandruff or dry eyes. Bacteria that live naturally on everyone's skin surface around the eyes may, in some people, develop on the skin at the base of the eyelids. This results in eye irritation, which, in combination with the occasional oily secretions due to increased activity of adjacent glands, creates “scales” or chalazia along the eyelashes and the eyelids.

Image 2: Chalazion

In blepharitis, both eyelids are covered with oily secretions near the base of the eyelashes. The eye is irritated and may be inflamed.

How can blepharitis be diagnosed?

In some cases, exfoliation or bacteria cause only a small irritation and itch, but in some cases they can cause redness, pinches, sand or burning sensation. Some people may develop allergies to exfoliation or the bacteria that surround them. This may lead to more serious complications, like inflammation of the tissues of the eye, especially of the retina.

How can blepharitis be diagnosed?

Blepharitis is diagnosed during an ophthalmological exam.

How is blepharitis treated?

Blepharitis can be a persistent problem. Even though there is no special treatment, it can be controlled through a regular hygiene program and with the help of medication.

How can blepharitis be treated through a hygiene program?

To keep blepharitis under control, you need to follow a regular program of eye hygiene.

At least twice a day, douse a clean towel in warm water (not hot). After wringing, place it on the closed eyelids for one to three minutes. As it loses temperature, douse it again once or twice. This will soften and loosen exfoliation and secretions. More importantly, it helps liquefy the oily secretions from the sebaceous glands of the eyelids, whichLight washing of the eyelashes (not the eye) with Baby Shampoo (which must be diluted with a 1 to 10 ratio).
If an antibiotic ointment has been prescribed, dab the base of your eyelashes (usually before sleeping at night) using the edge of your finger or a cotton swab, and gently rub the area.

Simple, everyday hygiene measures will reduce the number of additional medication needed to control blepharitis and its symptoms.

How much does medication help with blepharitis?

There are many drugs to treat blepharitis; they include steroids (cortisone) and antibiotics in the form of ointment or drops or, in some cases, they could be taken orally for systematic treatment both of severe blepharThese steroid medicines can be used to reduce the inflammation. While they often succeed in accelerating symptom relief, they may cause unpleasant side-effects after long-term use. That is why they should be administered only after an ophthalmological examination and not arbitrarily.

Antibiotics can be used to reduce the bacteria contained in the eyelids.

Artificial tears may be used to relieve symptoms of dry eyes (drops that don't need prescription – we suggest using a brand with no preservatives).

When the acute phase is over, something that can take a few weeks, some milder medication can help control blepharitis. We should, however, point out, that medication alone is not enough. Everyday cleaning routine, as described above, is quite important.

Remember: Your ophthalmologist is the best source for responsible answers on issues related to your eyes and their health. Under no circumstances is information taken from our website intended to replace him. Seek your doctor for complete information.