Introduction

Chalazion is an eye disorder that can affect anyone, regardless of gender or age, and is often confused with stye because of the similarity of symptoms between these two types of eye problems. Understanding the differences between these two conditions is, however, crucial to adopting the correct treatment.

Chalazion develops when one of the Meibomian glandslocated along the edge of the eyelids, becomes clogged, leading to a painless swelling.

This problem can be annoying and, if left untreated, can lead to more serious complications. In this article, we will explore the main causes of chalazion and the most effective remedies for dealing with it, offering practical advice that can be easily applied in daily life.

Aetiology

Chalazion is a common, but often not fully understood, eye condition. In this section we will elaborate on what a chalazion is and how it differs from a stye, another condition that can affect the eyelids.

What is a Chalazion?

A chalazio is a swelling that develops on the eyelid due to the obstruction of a Meibomian gland. These are special glands that produce a lipid substance that helps keep the eye lubricated. When one of these glands becomes obstructed, a chalazion forms.

Meibomian glands

The Meibomian glands are located in the tarsal part of the upper and lower eyelids. They have the function of secreting the lipid layerwhich is the outermost layer of the tear film and performs several important functions:
- defence of the corneal epithelium.
- control of the evaporation of the aqueous layer of the tear
- maintaining the correct hydration level of the cornea.

There are more than 50 Meibomian glands and they are located vertically next to each other in the two eyelids.

The Meibomian glands discharge their secretion along the eyelid rhyme through small holes called excretory ducts.

Chalazion: symptoms and frequency

Generally, chalazas are painless and can be confused with other eye conditions. They develop slowly and can become large enough to be a visual nuisance.

Fortunately, chalazas are not dangerous and often resolve on their own.

Anyone can develop a chalazion, but some people are more predisposed than others. For example, individuals suffering from blepharitis or rosacea tend to develop chalazia more frequently.

Differences with stye

Although chalazion and stye may seem similar, there are key differences between these two conditions.

L'stye is an infection of a gland in the eyelid, while the chalazio is a non-infectious formation, at least at an early stage.

Differential diagnosis

Styes tend to be more painful and appear more quickly than chalazas.

Moreover, stye are often associated with localised redness and swelling.

Main Causes

There are several factors that may contribute to the development of a chalazion. In this section, we will examine common risk factors and associated clinical conditions.

Hypercholesterolaemia

First of all, it must be emphasised that chalazions are more frequent in those with metabolic disorders, such as high cholesterol.

A diet too rich in fat and cholesterol can promote the formation of chalazio.

Risk factors

Other factors that may favour chalazion formation are:

• Uncorrected refractive defects (myopia, hypermetropia, astigmatism and presbyopia)
• Diseases of the intestinal tract, such as spastic colitis
• Hormonal imbalances
• Thyroid dysfunction
• Acne rosacea
• Seborrheic dermatitis

Incorrect behaviour

There are some improper behaviour which may increase the likelihood of developing a chalazion.

Here are some of the most common ones:

1. Inadequate eyelid hygieneNot regularly cleaning the eyelids can encourage the accumulation of oily substances and debris.
2. Misuse of cosmeticsLeaving make-up (eyeliner, eye shadow and/or mascara) on the eyes overnight may increase the risk of blocking the Meibomian glands.
3. Genetic predispositionSome people have a greater tendency to develop chalazia due to genetic and metabolic factors.

Conditions such as the blepharitiswhich causes inflammation of the eyelids, may also increase the risk of chalazia.

Good periocular hygiene is, however, the first and fundamental rule for the prevention of chalazas.

Associated clinical conditions

Certain clinical conditions are closely linked to the development of chalazas. These include some infectious conditions and inflammatory conditions, the most common of which are blepharitis and acne rosacea.

The blepharitis is a chronic inflammation of the eyelids that can lead to blockages of the Meibomian glands. L'acne rosacea, a disease that affects the skin, can also affect the eyelids, making the glands more susceptible to blockages.

Some patients with these conditions may develop chalazi more frequently. It is, of course, important to treat related pathological conditions to reduce the risk of recurrent chalazas.

Symptoms and Diagnosis

Chalazion symptoms can vary and diagnosis often requires a thorough eye examination. In this part, we will discuss typical signs and the most effective diagnostic methods.

Recognising symptoms

Recognising the symptoms of a chalazion is the first step in treating it effectively.

The following are the most common symptoms:

• Swelling on the eyelid
• Feeling of heaviness
• Slight redness in some cases

Although chalazas are generally painless, a large chalazion can put pressure on the eye, causing discomfort. It is important not to confuse a chalazion with other conditions, such as stye or conjunctivitis.

Diagnostic Methods

The diagnosis of a chalazion is usually made during an eye examination, through a thorough examination of the eyelid rims. During the examination, the doctor will check:

• Appearance and size of eyelid swelling.

Treatment advice

For a non-pharmacological treatment, which is easy to carry out and can help a chalazion to resolve more quickly, one can resort to applying a lukewarm compress to the eyelid, prepared according to these directions:

• soak a clean handkerchief or sterile gauze in a basin of lukewarm water
• apply the handkerchief or gauze to the eyelid for between 5 and 10 minutes.
• repeat the pack 3-4 times a day.

One should never try to squeeze or pop a chalazion, as this risks causing an infection and aggravating the damage to the surrounding tissues.

Medical therapy

In the case of chalazas that do not heal spontaneously, the ophthalmologist may prescribe antibiotic therapy and, in rare cases, proceed with surgical removal.

Surgical removal of chalazion

Surgical removal of a chalazion is an outpatient procedure that involves incision and scraping of the inflamed cyst. It is performed under local anaesthesia and lasts about 15-20 minutes.

Anaesthesia consists of an injection of anaesthetic into the affected region, incision of the eyelid tissue and removal and cleaning of the inflamed gland; stitches are almost always necessary. Afterwards, the eye will be bandaged for a few hours.

• Singh S, Maity M, Arunasri K, Basu S. Meibum and lid margin microbiome in eyes with chalazion: exploring an infectious aetiology. Br J Ophthalmol. 2025 Apr 7:bjo-2024-325988. doi: 10.1136/bjo-2024-325988. Epub ahead of print. PMID: 40194825.
• Park JK, Vyas C, Dagi Glass LR. Chalazia: A Scoping Review to Identify the Evidence Behind Treatments. Ophthalmic Plast Reconstr Surg. 2025 Mar-Apr 01;41(2):134-142. doi: 10.1097/IOP.0000000000002840. Epub 2024 Dec 10. PMID: 39656051.