Chalazion Surgery: Everything You Need to Know

A chalazion is a rubbery, firm, painless bump or swelling that can develop within the eyelid. It occurs when an oil-producing gland in the eyelid becomes blocked. Chalazia (plural for chalazion) may form in the upper or lower eyelid, though the upper is more common.

A chalazion—especially a small one—will likely go away on its own over a period of days to weeks. If it persists or is large and causing symptoms like blurred vision or eye irritation, it may need to be surgically removed.

This article discusses why a chalazion may pop up, when surgery to treat it may be needed, and what's involved.

What Is a Chalazion?

A chalazion is a bump that forms in the eyelid just behind the eyelashes. Chalazia happen when a meibomian gland becomes blocked. The meibomian gland produces an oily substance that helps lubricate your eye.

Chalazia may be related to viral conjunctivitis, a viral infection of the eye, but they can also be related to eye conditions that cause inflammation, such as blepharitis and seborrheic dermatitis.

A chalazion usually does not hurt and often resolves on its own, though it may take a few weeks. You can treat a chalazion at home by applying a warm compress to your eyelid for 10 to 15 minutes four or more times a day. You should never squeeze or attempt to pop a chalazion.

Chalazia are benign, which means they are not cancerous. A chalazion can look similar to a certain kind of cancer, however, so if you have one that does not seem to be improving over time, see your healthcare provider.

What Chalazion Surgery Entails

A chalazion that does not go away on its own may need to be surgically removed. Chalazion surgery is performed by an ophthalmologist or oculoplastic surgeon, a doctor who specializes in plastic and reconstructive surgeries involving the eyelids and certain other parts of the face.

During this outpatient procedure, the surgeon makes an incision in the eyelid and removes the oily content of the chalazion with a surgical tool called a curette.

The surgery may be performed in adults or children. Local anesthesia or general anesthesia may be used, though the latter is more common for young children.

Contraindications

Any of the following may prevent you from being able to have chalazion surgery:

• The chalazion is located near the punctum of the eye (the small opening in the corner of the eye where tears flow out)
• Inability to hold still, though a sedative may be recommended so the surgery can be done
• Allergy or sensitivity to anesthesia

Potential Risks

Possible risks involved with chalazion surgery include:

• General risks of surgery (e.g., bleeding, bruising, infection)
• Recurrence of chalazion or development of a new chalazion
• Eyelid notching or dimpling
• Misdirected or abnormally positoned eyelids (trichiasis)
• Loss of eyelashes
• Eye injury
• Eyelid scar

Purpose and Indications

Chalazion surgery is done to alleviate symptoms and any negative impact the eyelid bump is having on a patient.

Specifically, surgery may be indicated if:

• The chalazion persists despite nonsurgical therapies (warm compresses over the eye, gentle eyelid massages, prescription steroid ointment)
• The chalazion/eyelid is infected and not improving with antibiotics
• The chalazion is large and causing symptoms (e.g., blurry or decreased vision, astigmatism, watery eyes, eye discomfort)

Keep in mind that while being assessed for chalazion surgery, your doctor may suggest an alternative, less invasive treatment—injecting a corticosteroid into the chalazion.

Steroid injections for chalazia are intended to reduce inflammation and the redness, swelling, and tenderness it causes. While considered safe and potentially helpful, permanent lightening of the skin may occur around where the shot was given.

If chalazion surgery is a go, further medical clearance will likely be needed if general anesthesia is planned. This clearance can usually be accomplished through a visit with a pediatrician or primary care physician.

How to Prepare for Chalazion Surgery

At your pre-operative appointment, your doctor will review the steps involved in your surgery, including the preparatory and recovery processes.

Location

Chalazion surgery is performed in an office-based facility, outpatient surgical center, or hospital. The last two are the only locations where a procedure involving general anesthesia can be done.

What to Wear

Wear loose-fitting, comfortable clothes on the day of your surgery. You may want to wear a shirt or blouse that buttons or zips in the front so you don't have to pull it over your head at the end of the day when you are home.

Something that is easy to take off/put back on is best if general anesthesia is planned, as you will be required to change into a hospital gown upon arrival.

Finally, avoid putting on makeup on the day of your chalazion surgery. If you normally wear contact lenses, be sure to wear glasses that day.

Food and Drink

If undergoing general anesthesia, avoid eating, or giving any food to your child, after midnight on the eve of surgery. Clear liquids may be allowed up to two hours prior to your scheduled arrival time.

Medications

Patients can probably take their usual medications on the day of chalazion surgery. But there are some exceptions, including medications that may increase the risk of bleeding, like nonsteroidal anti-inflammatory drugs (NSAIDs).

Double-check this with your doctor beforehand to be certain.

What to Bring

On the day of surgery, bring your ID and insurance card. Also, bring along someone to drive you home after your procedure.

If your child is undergoing chalazion surgery, consider bringing their favorite stuffed animal or toy to help soothe them after the procedure is over.

Pre-Op Lifestyle Changes

For adults undergoing general anesthesia, stop smoking as soon as possible prior to surgery.

What to Expect on the Day of Surgery

Here is what you can generally expect before, during, and after chalazion surgery.

Before the Surgery

Upon arrival at the hospital, doctor's office, or surgical center, you will be led into a small pre-operative/holding area. If you are getting general anesthesia, you will be asked to change into a hospital gown at this time. A nurse will then place an intravenous (IV) line in your arm.

Your doctor will then come to greet you and briefly review the procedure with you.

From there, you will walk into the procedure/operating room.

If your child is having chalazion surgery with local anesthesia, they may be given a sedative to help them fall into a deep sleep first.

During the Surgery

Chalazion surgery takes about 20 to 45 minutes to perform.

Here's how a procedure using local anesthesia proceeds:

• Numbing the area: The surgery will start with the surgeon injecting a numbing medication into your eyelid around the area of the chalazion. You may feel a stinging sensation and some discomfort during the injection.
• Positioning and incision: Next, your surgeon will use a clamp to hold your eyelid open during the procedure. They will then make a small incision in either in the front or back of the eyelid depending on the size of the chalazion. If a large chalazion is present, the incision is generally made on the front of the eyelid.
• Removal: A curette will then be used to remove the contents of the chalazion. A cotton swab will be placed on the wound site to stop any bleeding. The clamp will then be removed, and the doctor will apply pressure to the wound site with his gloved finger pads.

Typically, the incision site is usually left to heal on its own. But if a large chalazion is removed, the surgeon may close the incision site with dissolvable stitches.

Contents of the chalazion may be sent to a lab, especially if the chalazion has been present for a long time or is a recurrent one. A pathologist will examine the contents to rule out potential eyelid cancers.

After the Surgery

If you underwent local anesthesia, you will be able to go home right after the procedure.

If you underwent local anesthesia with sedation or general anesthesia, you will be taken to a recovery area to slowly wake up. Once you are fully awake and ready, you will be discharged home with post-operative instructions.

Recovery From Chalazion Surgery

Recovery is expected to take around a week, although the timeline may be slightly shorter or longer depending on the location and size of the chalazion.

You may experience some minor and temporary side effects from chalazion surgery, including:

• Eyelid discomfort, bruising, and swelling
• Slightly blurry vision
• Minimal oozing of red fluid from the surgical site

As you recover at home, your surgeon may advise:

• Using cold compresses on your eye to reduce swelling
• Taking Tylenol (acetaminophen) for any eyelid discomfort
• Applying an antibiotic eye ointment or drops to help prevent infection
• Avoiding contact lenses, touching your eyes, and wearing eye makeup to help prevent infection
• Avoiding heavy lifting, bending, and strenuous activity to help reduce bruising
• Wearing an eye patch that you can remove on your own the morning after surgery

You can likely resume your normal work and household activities right after surgery as well, so long as they don't involve the above restrictions.

Your doctor will ask to see you at a follow-up appointment a week after your procedure.

Long-Term Care

Even though recovery from chalazion surgery is relatively short, your eyelid may remain slightly inflamed for several weeks. As a result, your doctor may ask to see you again in a couple of months after surgery to make sure everything has resolved.

For the long-term, you will also want to try and prevent new chalazia from forming.

Helpful habits to consider include:

• Adopting a daily eyelid-cleaning regimen: Use baby shampoo or pre-moistened eyelid cleansing pads to gently scrub your lid margin (where your eyelashes emerge).
• Getting into the habit of washing your hands often, especially before touching your eyes
• If you wear contact lenses, cleaning them properly and throwing disposable contacts away on schedule
• If you wear makeup, replacing your eyeshadow, eyeliner, and mascara every couple of months and cleaning your eye makeup brushes with mild dish soap or baby shampoo every two weeks

In some instances, certain complementary therapies may be recommended to help combat eyelid inflammation, such as omega-3 supplements and/or flaxseed oil. Be sure to only use these treatments under the guidance of your doctor.

Possible Future Surgeries

Future surgical interventions may be required if new chalazia form and/or if a complication from surgery develops.

A Word From Verywell

If you think you have a chalazion, try not to worry yourself too much. In the vast majority of cases, these eyelid bumps get better with simple, at-home therapies.

In the event that you do end up needing surgery, the good news is that your outcome should be excellent.