What Is a Chalazion? Symptoms, Causes, Diagnosis, Treatment, and Prevention

A chalazion (pronounced ka-LAY-zee-un), also known as a meibomian cyst, is a type of fluid-filled bump on the upper or lower eyelid.

Chalazia (plural of chalazion) are sometimes confused with sties. A chalazion is a firm, painless lump that develops within the eyelid when an oil gland becomes obstructed or blocked. (1) A stye is basically an abscess of the eyelid and typically occurs when an oil gland at the edge of the eyelid becomes infected with bacteria, resulting in a pus-filled lump or pimple that can hurt. (2)

The primary sign of a chalazion is a lump inside the upper eyelid.

Less commonly, chalazia may develop inside the lower eyelid. A chalazion may be accompanied by increased tearing.

If a chalazion progresses to the point of inflammation, it can cause the area around it to become red, swollen, and painful. (1)

Meibomian glands, or tarsal glands, are located within the eyelids near the lashes. They produce a thin, oily lubricant that prevents evaporation of the tear film — the thin layer of tears that covers the outer surface of the eye (the cornea). (3)

“If that oil inside starts to thicken, that forms a reaction in the eyelid that produces this bump in your eyelid,” says Sonul Mehta, MD, assistant professor of clinical ophthalmology at Penn Medicine in Philadelphia.

Both chalazia and sties are often a complication of blepharitis, a chronic inflammation of the eyelids. Conditions that cause meibomian gland secretions to become unusually thick, such as meibomian gland dysfunction and ocular rosacea, may also cause chalazia to develop. (4)

Additionally, the following conditions or factors are associated with an increased risk of developing a chalazion: (5)

• A prior chalazion
• Demodicosis (demodex mite infestation)
• Low vitamin A levels in the blood
• Gastrointestinal inflammation
• Smoking

Diagnosis of a chalazion involves a comprehensive eye exam. Your optometrist or medical provider will start by obtaining your medical history to understand your symptoms and any health problems you may have that could contribute to your eyelid issues.

Your doctor will then examine your eyes, looking at your eyelid structure, skin texture, and the appearance of your eyelashes. Usually this is enough information to make a clinical diagnosis, though rarely the doctor will obtain a sample of fluid from the chalazion for lab testing. (6)

Prognosis of a Chalazion

Chalazia typically heal on their own. The prognosis with treatment is excellent in most cases. (7)

“As long as there is no infection, a chalazion typically only lasts a few weeks provided it’s treated properly,” says Dr. Mehta.

To help the cysts heal, doctors recommend applying warm compresses to the affected eyelid for 10 to 15 minutes, 3 to 5 times a day. (2) “The warm compresses kind of ‘melt’ that oil and allow it to drain through,” says Mehta.

You can also try to help the chalazion drain by gently massaging the eyelid for several minutes a day; but never try to push, squeeze, or “pop” the cyst. (8)

Medication Options

Doctors do not typically treat chalazions with systemic medication, like oral antibiotics. But sometimes a chalazion can prompt an inflammatory reaction or become infected, says Mehta. “Depending on the diagnosis, we will treat it with a topical steroid or antibiotic, or an antibiotic/steroid combination ointment or drop,” she says.

Alternative and Complementary Therapies

The best treatment for a chalazion is a clean, warm, moist washcloth placed over the closed eyes a few times a day. Some people use warm tea bags, but there is no evidence that this is any better than the recommended warm washcloth. (9)

Prevention of a Chalazion

Good hygiene can help reduce your chances of developing chalazia: (8)

• Wash your hands often, especially before touching your face and eyes.
• If you wear contact lenses, wash your hands before and after removing them. Follow the recommended procedures for cleaning your lenses, and if you wear daily- or weekly-use lenses, discard them on the schedule recommended by your eye doctor.
• Wash your face every night before bed.
• Throw away old makeup and replace eye makeup every two to three months. Don’t share or use another person’s eye makeup.

“If a chalazion doesn’t drain on its own after treatment with compresses, sometimes we do an incision, which helps drain the bump and let that thickened oil come out,” says Mehta.

A chalazion that doesn’t go away within a few weeks should be evaluated by a doctor, says Mehta. “At that point, we want to be sure that we are pursuing the correct treatment and that the bump isn’t something else. Not all lumps on the eyelid are the same, and so it’s important to make sure that it’s not another type of nodule,” she says.

A chalazion that becomes very large can cause blurred vision if it presses against the eyeball. (1)

Chalazia are the most prevalent type of inflammatory lesions of the eyelid and account for approximately 13 percent of all benign (not cancerous) lid lesions. Adults are more likely to develop a chalazion than children are, with these cysts occurring most frequently in people between the ages of 30 and 50. (11)

A sty (hordeolum) is an acute bacterial infection of the oil gland, says Mehta. “That’s different from a chalazion, which is more of a sterile inflammation of the gland and not an infection,” she says.

Blepharitis is a type of eyelid inflammation that usually affects both eyes along the edges of the eyelids. It often occurs when the tiny oil glands near the base of the eyelashes become clogged. The irritation and redness caused by blepharitis can be painful, but it doesn’t cause permanent damage to eyesight and it’s not contagious. (12)

National Eye Institute (NEI) conducts and supports vision research and education programs that protect and prolong vision. This organization provides information about eye conditions, healthy vision tips, and information on clinical trials.

ClinicalTrials.gov lists any ongoing or recently completed clinical trials for eye conditions.

Chalazion Support is a support group on Facebook for anyone experiencing a chalazion, whether for the first time or as a recurring problem.

Additional reporting by Becky Upham.