Patient will present as → a 52-year-old male with a foreign-body sensation in the right eye. Over the last 3 weeks, he has had gradually increasing painless swelling around the right lower eyelid. Your examination shows a nontender discrete nodule on the right lower eyelid. There is no evidence of injection or discharge and her visual acuity is normal.
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Chalazion are relatively painless lesions (in comparison to a hordeolum which is a "hot", painful lesion)
- They are characterized by their insidious onset with minimal irritation
- A chalazion is noninfectious obstruction of a meibomian gland causing extravasation of irritating lipid material in the eyelid soft tissues with focal secondary granulomatous inflammation
- Remember: “C” = Chalazion = Chronic and “Cold” (versus hordeolum which is “hot”, acute and not chronic)
- Will present as a hard, nontender eyelid swelling, often not very red
- Chalazion occur more commonly in the upper eyelid because of the presence of more sebaceous glands
"A good way to remember which is painfull and painless: chalazion are too "lazy" to cause pain."
Diagnosis is clinical
- Will present as a hard, nontender eyelid swelling, often NOT very red
- Unlike a hordeolum (stye), a chalazion tends to have a more gradual onset, is less painful, and affects the middle part of the eyelid
Treat with warm compresses, and eyelid hygiene
- Injection of corticosteroid or incision + curettage may be necessary for large ones affecting vision
Question 1 |
The presence of pus Hint: see answer for explanation | |
hordeolum only appear on the lower eyelid Hint: hordeolum may appear on the upper or lower eyelid | |
pain Hint: see answer for explanation | |
visual changes Hint: neither chalazion or hordeolum should cause visual changes, although if big enough they could partially obstruct the visual field. | |
both A and C |
Question 2 |
Systemic antibiotics | |
Warm compresses Hint: See answer | |
Incision and curettage Hint: See answer | |
corticosteroid therapy injection Hint: See answer |
Question 3 |
Chalazion | |
Dacryocystitis Hint: Dacryocystitis is an infection of the lacrimal sac due to obstruction of the nasolacrimal system. | |
Entropion Hint: Entropion is an outward turning of the lower lid. | |
Hordeolum Hint: A hordeolum is a bacterial inflammation of the base of the eyelash. |
List |
References: Merck Manual · UpToDate