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Ask Dr. A.S. Desai Your Own Question

Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2092
Experience:  MS Ophthalmology with 11 years of surgical expereince
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I was diagnosed on 12/31 with a chalazion on my right lower

Resolved Question:

I was diagnosed on 12/31 with a chalazion on my right lower eyelid. It is very red. It does not block my vision in any way. Today is 6 days since I began using "Neo-Poly-Dex" ointment in eye just at bedtime. When I wake up in the morning I have a headache in that eye only. I have been doing warm compresses and lid scrubs 4-5 times a day for 10 minutes. The lower eyelid is still red. The eye doctor tried to drain it on 1/3 when I saw him, but nothing came out. I also have an ugly pimple on my cheek which does not have a "head". Could this whole thing be an infection instead that requires internal antibiotic? The doctor is an Opthamologist who specializes in eyelid surgery and conditions. Separately, can the chalazion go away on its own. Will I be scarred if they inject a steroid into the chalazion?
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 1 year ago.

Dr. A.S. Desai :

Hello, Welcome to Pearl.com

Dr. A.S. Desai :

Are you available for chat now?

Customer:

Yes

Dr. A.S. Desai :

A chalazion is a chronic inflammatory condition involving the meibomian glands(modified sebaceous glands in the eyelids). It is non tender, painless and is present usually for weeks .

Dr. A.S. Desai :

The skin over the chalazion is usually not red as it is not an acute condition/infection.

Dr. A.S. Desai :

However a chalazion can get an acute infection thus causing the swelling to become painful and tender( called internal hordeolum). In such a situation oral antibiotics are indicated.

Customer:

So far 2 doctors have said this is a chalazion, both being ophthamologists. I went to the second doctor because he specializes in eyelid conditions. Could they both be wrong as to what it is.

Dr. A.S. Desai :

Otherwise the treatment protocol of a chalazion is pretty much the same . If it is indeed a chalazion then the treatment is warm compresses( as suggested) for 2-3 weeks or even more. If it persists inspite of this then intralesional steroid injection is tried for small chalazion. For lerger chalazion the treatment of choice is definitely an incision and currettege.

Dr. A.S. Desai :

If the doctors want to try an intralesional steroid injection of triamcinolone, it can be done without any scarring( from conjunctival side). However it will help only in case of small chalazia and not for large ones.

Dr. A.S. Desai :

Warm compresses and lid scrubs are very effective measures however they take more than a couple of weeks to show effect ( you would expect to see improvement within a few days).

Dr. A.S. Desai :

sorry you would NOT expect to see results within a few days.

Customer:

The actual red area is not painful but is very red. It sounds silly maybe but could something like this be cancer? It came about suddenly last Thursday when I was out of town. I just woke up with it that morning. I was really shocked to see it. During the night it had felt like someone had punched me in that eye, which was definitely not the case. I did have something like this happen to me about 2 years before, but the lesion was never red, sort of just colorless. Yet they both said it is a chalazion.

Dr. A.S. Desai :

I would suggest that you continue with the warm compresses and lid scrubs for another 2-3 weeks before considering a steroid injection. A chalazion is otherwise a harmless condition .

Dr. A.S. Desai :

Wow! Both the doctors felt it was a chalazion even though it appeared so suddenly(overnight). Your description sounds more like an internal hordeolum ( internal stye).

Customer:

Are you saying that I already should be seeing improvement ("you would expect to see improvement within a few days). I have been doing this since 12/28, the day I first noticed this.

Dr. A.S. Desai :

No , I am sorry about the typing error. The warm compresses and lid scrubs would take much longer than a few days to show improvement ( may take a week or more).

Dr. A.S. Desai :

It is definitely NOT cancer if that helps to know. Cancer can never appear overnight in a healthy eyelid .

Customer:

If I need oral antibiotics, what is the drug of choice in this case?

Dr. A.S. Desai :

A broad spectrum antibiotic such as Tab.Augmentin 625 mg, 1 tablet twice a day for 5 days would help.

Customer:

Would the treatment differ for an internal stye (hordeolum) than from what I am presently doing?

Dr. A.S. Desai :

No, it would be the same. You can continue with the warm compresses and lid scrubs for another week or two. If your doctor agrees then oral antibiotics can be started for 5 days.

Dr. A.S. Desai :

I can see that you are typing..... I'll wait for your reply....

Customer:

Thank you so much for all your responses. I just need to calm down and stop worrying so much about how it looks. Anyhow, you have answered all my questions very well. I guess this ends it for now!

Dr. A.S. Desai :

You are most welcome.

Dr. A.S. Desai :

Yes, you must keep cool and calm down and stop worrying : )

Dr. A.S. Desai :

It will surely disappear soon.

Customer:

Sorry, just last question please: Would it go away if nothing was done?

Dr. A.S. Desai :

Small chalazia do disappear with only warm compresses within 6weeks to 6 months. However larger chalazia do need surgical intervention and would not disappear without any form of treatment. A stye would disappear with warm compresses within 5-7 days.

Customer:

Thank you for all your input so much. Have a happy and healthy New Year!

Dr. A.S. Desai :

I wish you the same!

Dr. A.S. Desai :

Thank you and best wishes.



It was a pleasure to have answered this question.

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Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2092
Experience: MS Ophthalmology with 11 years of surgical expereince
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Expert:  Dr. A.S. Desai replied 1 year ago.
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