Chalazion

Subject: Medical and Surgical Nursing II (Theory)

Overview

An eyelid cyst known as a chalazion, or meibomian gland lipogranuloma, is brought on by inflammation of a blocked meibomian gland, often on the upper eyelid. Chalazion varies from styes (hordeolum) in size and often has no pain other than the soreness they produce when they enlarge ( chalazia tends to be larger than stye). After a few months, a chalazion may finally go away on its own, but most of the time, therapy is required.The oil in the gland thickens to the point that it cannot flow out, resulting in a chalazion. The gland is blocked by the very thick oil, yet the gland continues to generate oil. On rare occasions, the chalazion grows and penetrates the tarsal plate to the outside of the eyelid. In contrast to a purulent infection of the cilium, chalazion formation is caused by gland obstruction and sterile inflammation. A chalazion may develop after the acute inflammation of a hordeolum, in which case the lesion becomes less painful until it eventually stops being painful.

Chalazion

A meibomian gland lipogranuloma, also known as a chalazion, is a cyst in the eyelid that is brought on by inflammation of a blocked meibomian gland, typically on the upper eyelid.Chalazion varies from styes (hordeolum) in size and often has no pain other than the soreness they produce when they enlarge ( chalazia tends to be larger than stye). After a few months, a chalazion may finally go away on its own, but most of the oil in the gland thickens to the point that it cannot flow out, resulting in a chalazion. The gland is blocked by the very thick oil, yet the gland continues to generate oil. Without a place to go, the oil gathers in the gland and becomes an eyelid bulge. When the glands finally burst (open), the oil is released into the eyelid tissue and causes irritation.

Pathophysiology

When the meibomian gland becomes clogged and sebum secretions build up, a chalazion develops. Granulation tissue and persistent inflammation are the effects of the material's reaction. Edema typically only affects the conjunctival region of the lid because the big meibomian glands are located in the tarsal plate of the eyelid.

On rare occasions, the chalazion grows and penetrates the tarsal plate to the outside of the eyelid. In contrast to a purulent infection of the cilium, chalazion formation is caused by gland obstruction and sterile inflammation. A chalazion may develop after the acute inflammation of a hordeolum, in which case the lesion becomes less painful until it eventually stops being painful.

Signs and Symptoms

  • Swelling of the eyelid
  • Eyelid tenderness
  • Sensitivity to light
  • Increased tearing
  • Heaviness of the eyelid

Examination and Test

  • Medical History
  • Physical examination: the examination includes an inspection of the back of the eyelid and the eye itself.
  • Test for version

Treatment

  1. Warm compression: the primary treatment is an application of warm compresses for 10 to 20minutes at least 4 times a day. This may soften the hardened oils blocking the duct and promote drainage and healing.
  2. Topical antibiotic eye drops or ointment: (eg. Chloramphenicol or fusidic acid) are sometimes used for the initial acute infection but are otherwise of little value in treating a chalazion.
  3. Chalazia will often disappear without further treatment within a few months and virtually all will resorb within two years.
  4. If they continue to enlarge or fail to settle within a few months, then smaller lesion may be injected with a corticosteroid or larger ones may be surgically removed using local anesthesia.

A rare chalazion may recur and these will be biopsied to help rule out tumors.

Surgery for chalazion

This type of surgery is a simple procedure which is generally performed as a day operation and the patients do not need to remain in the hospital for further medical care. Chalazion removal surgery is performed under local or general anesthesia. Commonly, general anesthesia is administered in children to make sure they stay and no injury to the eye occurs. Local anesthesia is used in adults and it is applied with a small injection into the eyelid. The discomfort of the injection is minimized with the help of an anesthetic cream which is applied locally.

Nursing consideration before and after surgery

Before surgery

  • when surgery for chalazion is considered, a patient who take aspirin or any other blood – thinning medications are advised to stop taking them one week prior to the procedure as they may lead to uncontrollable bleeding.
  • There are several tests taken prior the surgery to make sure to make sure the patient is in good condition for the operation.

After Surgery

  • However, most patients are allowed to return home following the procedure. Rarely, individuals who have chalazion surgery are held overnight in the hospital. This covers situations where there were issues and the patient needed to be closely watched.
  • Using analgesics makes the healing process simple and quick. Most patients only have very minimal eye irritation, which is readily managed by using painkillers.
  • However, it is advised that patients refrain from having water in their eyes for up to 10 days following surgery.
  • To avoid infection and associated complications, patients are advised not to wear contact lenses in the afflicted eye for at least eight weeks.
  • Use of pad: After the operation, a pad and protective plastic shield are placed over the eye to exert pressure and stop blood from leaking out; these can be taken off six to eight hours later.

 

 

 

 
Things to remember
  • An eyelid cyst known as a chalazion, or meibomian gland lipogranuloma, is brought on by inflammation of a blocked meibomian gland, typically on the upper eyelid.
  • Chalazion varies from styes (hordeolum) in size and often has no pain other than the soreness they produce when they enlarge ( chalazia tends to be larger than stye).
  • After a few months, a chalazion may finally go away on its own, but most of the time, therapy is required.
  • The oil in the gland thickens to the point that it cannot flow out, resulting in a chalazion.
  • The gland is blocked by the very thick oil, yet the gland continues to generate oil.
  • On rare occasions, the chalazion grows and penetrates the
Questions and Answers

A chalazion, also known as a meibomian gland lipogranuloma, is a cyst in the upper eyelid caused by inflammation of a blocked meibomian gland.

  •  Swelling of the eyelid
  • Eyelid tenderness
  • Sensitivity to light
  • Increased tearing
  • Heaviness of the eyelid

Treatment

  • Warm compression: Warm compresses should be applied for 10 to 20 minutes, at least four times per day, as the main form of treatment. This could encourage drainage and healing by softening the duct-blocking hardened oils.
  • Topical antibiotic eye drops or ointment: (such as chloramphenicol or fusidic acid) are occasionally used for the initial acute infection, but they are ineffective in treating chalazion-related conditions overall.
  • Within a few months, chalazia frequently go away on their own, and within two years, almost all of them resorb.
  • Smaller lesions may be injected with corticosteroids if they continue to grow or if larger ones may be surgically removed under local anesthesia if they don't go away within a few months.

A biopsy will be performed on any recurrent rare chalazion to help rule out tumors.

Surgery for chalazion

The patients do not need to stay in the hospital for additional medical care following this type of surgery because it is a straightforward technique that is typically carried out as a day surgery. Under either local or general anesthesia, chalazion removal surgery is carried out. Children frequently receive general anesthesia to ensure their comfort and prevent eye injury. Adults use local anesthesia, which is administered via a tiny injection into the eyelid. With the aid of a locally applied anesthetic cream, the pain of the injection is reduced.

Nursing consideration before and after surgery

Before surgery

  • A patient who takes aspirin or any other blood-thinning medication is advised to stop taking them one week prior to the procedure as they may cause uncontrollable bleeding when surgery for chalazion is considered.
  • Before the surgery, a number of tests are performed to make sure the patient is healthy enough for the procedure.

After surgery

  • However, most patients are allowed to return home following the procedure. Patients are occasionally held overnight in the hospital following chalazion surgery. This includes situations where there were complications and the patient needed to be closely watched.
  • Using analgesics makes the recovery process simple and quick. Most patients only experience very minor eye discomfort, which is easily managed by taking painkillers.
  • However, it is advised that patients refrain from getting water in their eyes for up to 10 days following surgery.
  • To avoid infection and potential complications, patients are advised not to wear contact lenses in the affected eye for at least eight weeks.
  • Use of pad: After the operation, a pad and protective plastic shield are placed over the eye to apply pressure and stop blood from leaking out; these can be taken off six to eight hours later.

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