Chalazion in children is an uncommon ocular condition where a small, slow-developing lump resembling a stye appears on the eyelid; however, it is not the same. A stye is a painful lump on the eyelid resulting from a bacterial infection of the eyelash, while a chalazion is a painless bump caused by a blocked oil gland in the eyelid (1).
If left untreated, a stye can turn into a chalazion and vice versa (2). Chalazia are usually harmless and self-limiting, requiring only minor medical attention. However, it may not dissolve in some instances and may develop into chronic issues.
This post discusses the causes, diagnosis, and complications of chalazion and how it can be treated and prevented in children.
Why Does Chalazion Occur In Children?
Small oil glands called meibomian glands within the eyelids’ margins secrete oil to lubricate the eye surface and prevent it from drying out. When one or more of these glands get blocked, oil begins to build up inside them. It leads to the formation of a chalazion, a lump visible on the eyelid. It is why chalazion is also known as a meibomian cyst.
A chalazion is painless, but if left untreated, the oil build-up can rupture the gland. It is red and the swelling causes concern to the child and parents. Upon rupture, the leaked oil can irritate the eye and the eyelid, making the eye red, swollen, and painful (3).
What Are The Risk Factors For Chalazion In Children?
- Eyelid hygiene and care: Studies show that the collection and deposition of debris or foreign bodies on the eyelids can cause chalazion development. Regular cleaning and washing of eyelids to remove any deposits can help prevent chalazion.
- Frequent rubbing of the eyes with dirty hands or washing eyes with unclean water.
- Hormonal changes: Tween and teens experience rapid changes in androgen hormone, especially around puberty. These changes increase the production and secretion of sebum from the meibomian glands, increasing the risk of developing a chalazion.
- Chronic blepharitis: Blepharitis is the chronic inflammationof the meibomian glands and their ducts due to poor eyelid hygiene, excess sebum production, allergies, or bacterial infections (7). The inflammation in its chronic state leads to the blockage of the sebaceous secretion, causing chalazion formation.
- Acne rosacea: Acne rosacea is a chronic skin condition of unknown etiology wherein the central part of the face, that is, the cheeks, eyes, and nose, becomes red and flushed (8). This inflammatory condition can affect the skin surrounding the eyes and eyelids, causing chalazion development (6) (9).
- Seborrhea: Seborrhea or seborrheic dermatitis is a chronic, inflammatory skin condition affecting the sebaceous gland-rich regions, such as the scalp and face (10). Overgrowth of Malassezia yeast is the likely cause for the condition. Seborrhea could cause chalazion development when the condition affects the eyelids (6).
- Bacterial and viral infections: Although uncommon, bacterial and viral infections of the meibomian glands and its ducts can cause a chalazion. In such cases, the chalazion may lead to a stye. Staphylococcus aureus is a common bacteria known to cause chalazion. So a chalazion can also occur after conjunctivitis. A chalazion may also occur following follicular conjunctivitis or other systemic infection (6).
Some of the other risk factors for chalazion formation in children include eyelid injury or trauma, exposure to air pollutants, tuberculosis, and medical conditions, such as hyperlipidemia and diabetes.
What Are The Symptoms Of Chalazion?
A chalazion may develop on the upper or lower eyelids of one or both eyes. The following are the various signs and symptoms of a chalazion (2).
- A chalazion presents as a painless red lump on the eyelid, making the eye appear swollen with mild to no tenderness.
- It can make the eyelid feel heavy and may make the eyes watery.
- Depending on its location and size, a chalazion may press against the eyeball, causing redness in the conjunctiva (the layer of tissue that covers the eyeball). It may also blur vision or block it in extreme cases.
- In rare cases, with superadded bacterial infection, a chalazion may turn tender, red, swollen, and painful.
Since a chalazion’s symptoms resemble other medical issues, it is advisable to consult an ophthalmologist (eye specialist) to determine the precise cause.
How Is Chalazion Diagnosed?
There is no single test to diagnose a chalazion. Typically, an ophthalmologist will examine the bump on your child’s eyelid and discuss their symptoms. During the physical exam, they will check your child’s eyes, eyelids’ margins, and oil gland openings. They will also take details of your child’s medical history to ascertain the possible causes for chalazion development (2) (11).
How Is Chalazion Treated?
A chalazion is mostly benign and resolves on its own within a few weeks to a month with minimal medical intervention. Yet, if you are worried, consult an ophthalmologist and try the following (2) (12).
- Apply a warm compress to your child’s eyelid four to six times a day. Each time, keep the compression on the eyelid for about ten to 15 minutes. It may soften the hardened oil, triggering the blockage to open and allowing the oil to drain. You can make a warm compress by soaking a clean, soft, cotton cloth in warm water and then squeezing the water out. Instruct your child not to pop or squeeze a chalazion as it could have adverse effects.
- Gently massage your child’s eyelid for a few minutes a day. It will prompt drainage by putting mild pressure on the duct opening. If the chalazion drains, clean the area using a clean, soft cloth. Instruct the child to keep their hands away from the eye and use a clean cloth to dab their eye if it feels itchy. Tell them to wash hands before and after touching their eyes to prevent infections.
- Over-the-counter (OTC) medicines, ointments, and eye pads may help drain the blockage and control/prevent infection. If a chalazion gets infected, oral antibiotics, antibiotic eye drops, or antibiotic or anti inflammatory ointments or drops may be used. Consult a doctor before you use any medications and follow the correct instructions for use.
- Surgical drainage of a chalazion is an option when the chalazion doesn’t go away, or a large chalazion interferes with the vision. The chalazion is drained through an incision in this procedure. It is performed at a doctor’s office under local anesthesia.
The eye will be patched for a day or so after the drainage. There will be some redness, swelling, and pain in the eye for a few days after the removal of the eye patch. You may also notice a pinkish discharge for a day or so. However, if the discharge is yellow or green, it may indicate an infection, warranting immediate medical intervention (13).
In some cases, chalazia may recur, warranting continued treatment and medical monitoring. If a chalazion occurs at the same location often, the doctor may take a small sample of the lump tissue (biopsy) to determine the precise cause of chalazion recurrence.
How To Prevent Chalazion?
The following steps could ensure chalazion prevention in most cases.
- Guide your child to thoroughly wash their face, with soap or face wash, including the eye area, after waking up and before going to bed. It will help remove the excess oil and dirt stuck around the eyes.
- Instruct them to wash hands each time they touch their eyes or surrounding areas. If they wear contact lenses, they must wash their hands with water and soap before and after handling the lenses. a
- Show them how to use eyelid scrubs or eye wipes to clean the eyelids. Eyelid scrubs may help remove any crust or dirt particle covering the oil gland’s opening (13). A doctor can recommend an appropriate eyelid scrub for the purpose.
- Help them wash the eyes with cold water instead of rubbing them when they feel irritation in and around the eyes.
- Provide sunglasses and guide your child to use them as much as possible for sun protection. You may also provide them with safety glasses to protect the eyes from dust and dirt.
If your tween or teen uses eye makeup, tell them to change their makeup products every three to six months to prevent bacterial growth. They should also avoid sharing eye makeup with others and remove eye makeup before going to bed. The essential issue is cleanliness and hygiene of eyes.
When To See A Doctor?
It is advisable to see a doctor right away if:
- Along with chalazion, your child has a fever.
- The chalazion becomes painful, red, and swollen.
- The pain, redness, and swelling of the lump don’t resolve even after treatment and care.
- The chalazion is accompanied by other symptoms, such as fever, persistent headache, and severe eye irritation.
Chalazion in children is an uncommon condition that might require medical attention if it does not show signs of healing after a few days. It is usually painless and mostly occurs due to the frequent rubbing of the eyes or due to a lack of proper hygiene and care of the eyelids. Therefore, it is advised that you teach your child to wash and clean their face regularly and avoid touching their face and eyes with dirty hands. In case the chalazion becomes painful and causes irritation, consult your pediatrician immediately.
- Chalazion, also known as a meibomian cyst, is a painless lump on the eyelid.
- Poor eyelid hygiene, hormonal changes, and various skin conditions and infections can influence chalazion formation in children.
- Warm compression and gentle massage over eyelids and some OTC medicines, ointments, and eye pads may effectively treat chalazion in children.
- If a chalazion obstructs your child’s vision, consult an ophthalmologist for surgical drainage of chalazion.
2. Chalazion; American Optometric Association
3. Chalazion; Cleveland Clinic
4. Chalazion in Children; University of Rochester Medical Center
5. Who Is at Risk for Chalazia and Styes?; American Academy Of Ophthalmology
6. Alaa Alsammahi et al.; Incidence and predisposing factors of chalazion; International Journal Of Community Medicine And Public Health
7. Blepharitis And Chalazion; University Of Utah
8. What Is Rosacea?; American Academy of Dermatology Association
9. Ocular Rosacea; Eyecare Trust
10. Seborrhoeic dermatitis; DermNet NZ
11. Chalazion | Diagnosis & Treatment; Children’s Hospital
12. Chalazia and Stye Treatment; American Academy Of Ophthalmology
13. Chalazion; About Kids Health