Chalazion Surgery in London

A lump on the upper eyelid or lower lid that has recently appeared can be painful and unsightly. It can affect our confidence and how you perform at work. This page aims to explain the difference between the eyelid cysts that appear and how you may be able to manage these conditions yourself without surgical intervention.

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What is the difference between a stye, a hordeolum, a chalazion and meibomian cyst and how do you treat them?

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A Stye is a Hordeolum

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An internal stye is also known as a hordeolum and is usually a self limiting bacterial infection that affects on the glands of the eyelid. It results in a tender lump on the edge of the eyelid. The inside or the outside of the eyelid can be affected by a stye or hordeolum. The glands that become infected on the inside of the eyelid are known as the meibomian glands. The glands that become infected on the outside of the eyelid are known as the glands of Zeiss.

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Often a stye will go away on its own without treatment. It is recommended to use hot flannels or warm compresses to heat up the eyelid allowing the oils in the blocked oil glands to melt. Pressure is applied to the tender stye without squeezing the skin to encourage it do discharge and heal naturally. Occasionally antibiotic ointment may be required but there is limited evidence for its use. If the stye or hordeolum becomes associated with a skin infection known as cellulitis this would require a medical option and possible the use of oral antibiotics. It is important to seek an urgent medical opinion on the rare occasion that an eyelid swelling presents with fever, sweats, blurry vision, reduced visual acuity or double vision or swelling of the eyeball.

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A Meibomian cyst is a Chalazion

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A chalazion is also known as a Meibomian cyst is a cyst in the eyelid with sebaceous secretion due to a blocked eyelid gland of following a stye or External Hordeolum. There are two different types of gland in the eyelid that when blocked can lead to a chalazion; a Meibomian gland or a gland of Zeiss. Like a stye a large chalazion can present with a cellulitis and inflammation of the surrounding tissue making it tender and painful requiring antibiotics.

 

They can later settle to form a firm nodule, painless lump or painless swelling near the lid margin. In younger and older children they are common in the upper lid and lower eyelid. A recurrent chalazion in an older person may be a sign of sebaceous carcinoma or squamous cell carcinoma although this is less common. Treatment of chalazia is usually the use of hot flannels to heat up the eyelid and pressure again without squeezing of the skin. 

 

Risk factors include Meibomian gland dysfunction and conservative treatment with warm compresses help treat this condition as well. It is advised to use a clean washcloth and warm water with baby shampoo may be advised although this can irritate the eye. Chronic inflammation from a skin condition known Seborrheic dermatitis or Rosacea are also risk factors.

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Why is chalazion surgery done

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You may consider having surgery on your chalazion if you suffer from a persistent unsightly chalazion that is not settling with hot flannel, massage treatment was will as the possible use of anti-inflammatory eye drops. Steroid injection is a treatment option but has variable results.

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Surgical removal under local anesthesia and less commonly general anesthesia particularly in children is an option if you have:

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A persistent chalazion that is not resolving despite treatment with warm compresses and pressure

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Insurance coverage for chalazion surgery may depend on your policy. If the surgery is only to improve the cosmetic appearance to give a younger and brighter look the most likely won't be covered by your insurance policy. 

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Risks

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Possible risks of chalazion surgery which is carried out as a day procedure where you go home on the same day include:

 

• Infection

• Bleeding from the eyelids

• Dryness and irritation of the eyes

• Difficulty closing the eyes

• Scarring although this is usually on the under surface of the eyelid and not visible on the face

• A need for follow up surgery

• Temporary blurring of the vision

• Rarely, loss of vision

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To know which risks most apply to you talk to your doctor to understand more about chalazion surgery as well as the benefits and if they apply to you. This way you can decide with your doctor if chalazion surgery is a good option.

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How you prepare

 

Before having chalazion surgery you will meet your oculoplastic surgeon who specialises in blepharoplasty to discuss:

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• Your medical history including any previous surgery and current eye conditions.

• Your expectations with an honest discussion about what can be realistically achieved.

• A vision examination to check the eyes prior to surgery

• A physical examination of  the eyelids to ensure that this is the correct procedure.

• Eyelid photography which can help with surgical planning and to provide evidence for any insurance claim.

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It is preferable to stop taking any blood thinner medication such as aspirin, ibuprofen, warfarin, apixiban and any other medication that can cause increased bleeding during blepharoplasty surgery. Your doctor will discuss these with you to ensure that it is safe for you to do so prior to your chalazion surgery and will tell you how long before the operation.

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Stoping smoking several weeks before surgery can help improve the healing after chalazion surgery.

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You should arrange for someone to take you home after the procedure.

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What you can expect before the procedure

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Chalazion surgery is usually done as a day case where you can go home the same day. Your surgeon will inject anaesthetic into your eyelids to numb the area.

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What you can expect during the procedure

 

Your surgeon will make an incision along the under surface of the eyelid after injecting local anaesthetic, removing chalazion and allowing its contents to discharge.  A patch is placed on the eyelid for 4 hours and then removed. Any scar remains on the under surface of the eyelid and should not be visible to give a natural appearance.  Mr Ahmad Aziz specialises in the procedure and performs it in Central London.

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What you can expect after the procedure

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After surgery you are monitored for complications. You are able to leave later that day to recuperate and begin the healing at home.

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After surgery you may temporarily experience:

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• Blurred vision from the lubricating ointment applied to your eyes at the time of blepharoplasty

• Watering of the eyes

• Sensitivity to light

• Double vision

• Puffy, numb eyelids from the anaesthetic and chalazion surgery

• Swelling and bruising similar to having black eyes which will settle within a week

• Pain or discomfort

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Your doctor will likely suggest you take the following steps after surgery:

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• Use ice packs on your eyes every hour the night you go home after the operation. The following day, use ice packs on your eyes four to five times throughout the day to help reduce the swelling

• Gently clean your eyelids and use prescribed medication.

• Avoid straining, heavy lifting and swimming for a week after chalazion surgery.

• Avoid strenuous activities, such as aerobics and jogging, for a week.

• Avoid smoking.

• Avoid rubbing your eyes.

• Not to use contact lenses for about two weeks after surgery.

• Wear darkly tinted sunglasses to protect the skin of your eyelids from sun and wind.

• Sleep with your head raised higher than your chest for 3 days after the surgery.

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Seek medical attention immediately if you experience any of the following:

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• Shortness of breath

• Chest pain

• An unusual heart rate

• Severe new eye pain

• Bleeding

• Vision problems

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Results

 

Many patients are satisfied with the results of chalazion and benefit from a more natural appearance, better vision if the peripheral field was being obstructed and more self confidence with the reduction of the eyelid lump. The results of the surgery can last a lifetime but for others a chalazion can recur with time. 

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The bruising and swelling noticeably settle within 2 weeks resorting a more natural look giving you confidence in going out publicly. 

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Scars from the surgery can take months to fully fade but should be on the under surface of the eyelid and well covered. You should protect your eyelids from too much sun exposure as you should do for the rest of your skin. Recurrent chalazia can occur due to a blocked gland in the sebaceous glands around the eye.

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