CHALAZION

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Chalazion/Tarsal Cyst/Meibomian Cyst

Cleared controversies Drainage by transconjunctival vertical incision & curettage(no suture)

Chalazion is	Sterile Chronic non infective(non suppurative)lipogranulomatous inflammation of meibomian glands(not a cyst) or sometimes Zeis
more common among	adults > children
Results from	Obstruction of meibomian gland duct Due to low grade infection
The glandular tissue is replaced by lipogranuloma; the large pale cells are epithelioid cells and the well demarcated empty space contained fat dissolved out during processing	extracellular fat deposits surrounded by multinucleated giant cells,lipid laden epithelioid cells,plasma cells, histiocytes and polymorphonuclear leucocytes Non Inflamed chalazion
CF Marginal chalazion Conjunctival granuloma	Painless,non tender swelling of the lid Slightly away from lid margin(often) Marginal chalazion - located on intermarginal strip Signs of acute inflammation are rare(unless sec infection occurs)       Acutely inflamed chalazion Blepharitis is commonly present
complications	Blurred vision(astigmatism) Recurrence occur in seborrheic dermatitis,acne rosacea,malignant change Secondary malignancy - meibomian gland carcinoma (Sebaceous cell carcinoma)(chance of misdiagnosis) Hordeolum internum(d/t secondary infection)
Recurrent chalazion predispose to	Adenocarcinoma
Management	Hot fomentation,topical antibiotics,oral anti inflammatory drugs Intralesional steroid Drainage by transconjunctival vertical incision & curettage(no suture) Diathermy for marginal chalazion Recurrent chalazion with acne rosacea and seborrheic dermatitis - systemic tetracycline