The formation of a chalazion cannot always be explained. However, chalazions are more common in people who suffer from blepharitis (an inflammation of the eyelids accompanied by excessive sebum production) and rosacea or seborrheic dermatitis. People with rosacea have redness and pimples on their face and are prone to problems caused by excessive sebum production, such as blepharitis.

A stye can be internal or external. An internal stye is a small abscess caused by infection of the meibomian glands with staphylococcus, while an external stye (small stye) is an acute small staphylococcal abscess in the follicle of an eyelash and in the corresponding gland of Zeis and Moll.

Chalazia and stye are often confused. However, a chalazia is an aseptic inflammation, which is not due to a microbial agent, but to the blockage of the opening of a meibomian gland of the eyelid, which can be secondarily infected, while a stye is an acute infection of the eyelash follicle and has the form of a red, painful lump near the eyelid margin. Chalazions usually appear away from the eyelid margin, while a stye tends to peak towards the nasal part of the eyelid. Sometimes a chalazion can cause sudden swelling of the entire eyelid.

Both appear as inflammatory swellings of the eyelid. The eyelid appears swollen, red and painful especially when pressed. They can appear on the upper or lower eyelid at any point, with a stye preferentially away from the eyelid margin and a stye close to the eyelid margin. If the inflammation is severe and especially affects the upper eyelid, then the eyelid tends to close. If the stye that is created is large, it causes not only an aesthetic but also a functional problem (e.g. drooping of the eyelid from a large stye of the upper eyelid or astigmatism from a large stye that presses and deforms the cornea). A white spot may be visible in the stye, which indicates the presence of pus.

If you are prone to the formation of chalazia, then your ophthalmologist can guide you on proper eyelid hygiene and their avoidance. Meticulous cleaning of the eyelids on a daily basis reduces the possibility of gland blockage. This cleaning is done either with baby shampoo or with special preparations in foam form or in wipes, which are available on the market. In addition, the adoption of certain dietary habits, without being a panacea, certainly helps both in preventing the recurrence of cataracts and in improving health in general. The consumption of foods high in vitamin A (fish such as salmon and tuna) should be increased. The consumption of B-carotene is also essential since it is converted into vitamin A in the body.
Include foods rich in vitamin B6 in your diet – vegetables (peas and beans), tuna, salmon, chicken and vitamin B3 (sunflower seeds). Fresh salads are also a particularly useful food.
Drink plenty of water, at least 6 glasses a day, and avoid fatty foods in large quantities.

Oral antibiotic treatment aimed at balancing the normal flora of the eyelid area. The most common oral treatment for meibomian gland dysfunction is doxycycline, tetracycline or minocycline, which belong to the same class of antibiotics. Doxycycline, however, is generally better tolerated. Topical and systemic antibiotics are usually ineffective in chalazions that are not involved by a microbial agent.

Internal styes may require incision and drainage if a lump remains after the acute infection has resolved. External styes usually do not require any treatment because they usually resolve on their own or drain near the root of the eyelash. Warm compresses with water may accelerate the spontaneous rupture and drainage of the stye’s contents. Systemic antibiotics are only needed in cases where the stye causes preseptal orbital cellulitis, i.e. extensive inflammation in the surrounding area.

Many chalazions can heal on their own by spontaneously rupturing. Sometimes, however, chalazions persist for several weeks and become quite large. Initial treatment should be with a combination of topical eye ointments and eye drops with a pure antibiotic or a mixed antibiotic with topical cortisone. Warm compresses are also quite helpful before using the eye drops or ointments, because they increase the absorption of the drugs by causing local hyperemia, but they can also help in the rupture of the chalazion and its drainage. It is important to start treatment with the appearance of the first symptoms, because if the inflammation becomes chronic, then a granuloma is created, which is resistant to local cyst treatment. In this case, the only treatment is surgery. So if the chalazion does not subside after 3 or 4 weeks, then only surgical opening and drainage can provide a solution. In summary, the initial treatment includes:

Topical antibiotics or a combination of antibiotics and steroids for 10-15 days. Warm compresses with water for 5-10 minutes just before instillation of the eye drops in combination with massage of the area. If the chalazion does not subside with all this, then surgical opening and drainage is performed.

It is a procedure that does not require a hospital stay. After instillation of anesthetic drops, you will be given an anesthetic injection under the skin, next to the cyst, so that you do not feel pain. Then, after the ophthalmologist turns the eyelid over, he makes one or more small vertical incisions on the inside of the eyelid and removes the contents of the cyst along with part of the wall. Finally, a pressure eye patch is placed on the eye, which should be left on for at least the next 6 hours in order to avoid postoperative bleeding. You may notice a bruise on your eye, which will, however, be absorbed within the next few days. Your doctor will give you antibiotic drops or ointment that you should use 4 times a day for at least a week.
If a chalazion recurs, then a more thorough examination is performed to determine the cause of the recurrences and if it is in the same location, a biopsy is needed.

Up to 50% of cases are associated with elevated blood cholesterol levels, but they can also be of idiopathic origin.

When they bother the patient for aesthetic reasons, then the xanthelasmas are removed under local anesthesia. A small incision is made in the eyelid at the point where the plaque is, so that it is completely removed and sutures are placed. The incisions are made in the normal folds of the eyelid skin so that they do not leave a visible mark. Surgical removal of xanthelasmas does not require hospitalization. There is a possibility of recurrence, but this is small.

The patient returns home the same day, with the doctor’s instructions, and the stitches are removed after 5-7 days. The scar follows the body’s natural healing process, which is different for each patient, but the appearance gradually improves in 4-8 weeks.

Xanthelasma can also be removed by laser, chemical cauterization and electrocautery. These methods are indicated for smaller and superficial xanthelasma. With laser, the likelihood of recurrence is higher compared to surgical removal and there is also a risk of hyperpigmentation/hypopigmentation in the area where the laser was performed, while chemical cauterization often requires multiple sessions.