The quickest and easiest way to get rid of a chalazion!

Having a lump on your eyelid is not the worst eye problem you can suffer from, but it is annoying, can be uncomfortable and is often recurrent or persistent. An eyelid cyst is a common reason why people seek advice from their GP or an ophthalmologist. An eye cyst is also known as a chalazion, a stye or hordeolum.

What is a chalazion?

A chalazion can affect the upper or lower lids and occur because of blockages in the glands that open onto the eyelid margin or the base of the eyelashes. This causes the blocked tunnel to swell, become enlarged and distended and may in some cases cause infection to the surrounding layers of the skin. The symptoms range from the nuisance of having a pea-sized lump on your eyelid to redness, pain and mucky discharge from the blocked gland.

What is the easiest way to get rid of a chalazion?

Applying heat

The key to getting rid of it as soon as possible is to apply heat directly to the affected lid to dilate the blocked gland opening. This will also soften the trapped material within the blocked duct, making it easier for it to be massaged out with gentle pressure.

The key to doing lid heat and massage effectively is to aim for 1-2 minutes of heat and to use a cotton flannel or muslin, as they are thicker than cotton wool and will hold the heat for longer. Warm tap water is fine for heating the cloth, and it should feel soothingly warm rather than very hot.

You will need to rewarm your flannel under the tap to achieve 60-90 seconds of heat and make sure you are holding it over the opening to the blocked duct or gland. Often people hold the flannel around the eye socket, but this is too far away from the affected area to be helpful. After 1-2 minutes the duct opening should be more open and the trapped contents slightly softer and easier to express.

Massaging the chalazion

You should use your fingers to apply pressure to the cyst, massaging upwards if it is on the lower lid, or downwards if it is on the upper lid.

Your aim is to get the infected or stagnant contents to discharge onto the surface so that you can wipe them away.

The discharge can be green, grey, white or bloodstained and you will often notice an immediate reduction in the size of the cyst when expressed.  If your eyelid is very sore when you try to press or massage it, it is worth taking some paracetamol to help you tolerate the manipulation better.

A spreading infection can cause a chalazion

If you have a fever, or redness that is spreading rapidly across the skin of your eyelid, then you need to see a doctor to consider oral antibiotic treatment. In some cases, ophthalmologists associate a chalazion with infection spreading in the surrounding skin, a condition known as pre-septal cellulitis.

This can be more common in patients with diabetes or other chronic conditions pre-disposing them to infection, or for those with a suppressed immune system.

In these cases, oral antibiotics will help to settle the skin infection. However, the cyst still needs heat and massage. It is essential that children with eyelid cysts who develop associated skin infections are assessed promptly for oral or intravenous antibiotics.

The eyelid has several layers and one of those, the septum, separates the outer layers from the inner layers. In adults, the septum has developed fully, and this layer stops a superficial infection from spreading deeper into the tissues around the eyeball and, ultimately, the brain.

In children, however, the eyelid septum has not developed fully, and superficial infection may spread rapidly into the deeper eye socket and the brain.

This is not a common scenario, but if a child has a chalazion that is red, hot and sore, then you should seek medical help promptly. If the chalazion is skin-coloured and there is no fever, then a child’s chalazion can be treated in the same way as an adult’s, with heat and massage.

When should I consider a surgical option for a chalazion?

The majority of eyelid cysts settle with good, consistent heat and massage, and only a minority will need a minor operation.

Patients choose to seek an ophthalmic opinion if the cyst has been there for a long time or if they feel it inhibits how they go about their day-to-day activities – avoiding eye contact with others, interfering with contact lens wear, vision or sporting activities and generally making them more self-conscious.

As a chalazion is not a serious eye problem, many hospitals and GPs cannot operate on or refer these cysts to NHS services for a surgical opinion.

Often the chalazion has to be there for six months or severely and demonstrably interfering with vision before the NHS can assess suitability for surgery. Many people choose private care as these rules don’t apply and the operation is the same.

When I am assessing patients with chalazia, I first make sure that they have tried conservative heat and massage treatment appropriately.

With patients for whom early surgery is the right option, we can usually schedule the procedure very quickly, and this is the advantage of private care. This short timescale can be very important for patients who are getting married, starting new jobs or have other important life and social events due imminently.

Incision and curettage is the minor operation we carry out for chalazia. You can read all about this procedure here. 

Effective treatment options.

Remember, chalazia can be recurrent and annoying. Effective treatment involves:

1.  Starting the heat and massage routine immediately and carrying it out at least twice a day. Regular, consistent five-minute lid care twice a day is better than 30 minutes once a week.
2. Apply the warm, wet towel to the eyelid margin over the cyst, not the skin of the eyelids. The blocked opening is on the edge of the eyelid, not on the skin
3. If a child has a chalazion, with spreading redness in the surrounding skin and a fever, they need to see a doctor urgently for antibiotics to stop the infection spreading into the deep tissues around the eye and the brain.
4. Conservative treatment works for most people but if the cyst is persistent, and just won’t go away, then explore the option of minor surgery with a friendly and experienced consultant who can talk you through the procedure and discuss what is right for you.