Chalazion surgery: When is it necessary and What to expect

A chalazion is a common eyelid condition that can lead to discomfort, swelling, and cosmetic concerns. While many chalazia resolve on their own or respond to conservative treatments, some may persist and require surgical removal.

Understanding when chalazion surgery is necessary—and knowing what to expect before, during, and after the procedure—can help individuals make informed decisions about their eye health.

What is a chalazion?

A chalazion is a painless lump or swelling that develops on the eyelid due to a blocked meibomian gland—these glands produce the oily layer of the tear film that prevents eye dryness. When a gland becomes clogged, the oil backs up and causes inflammation, forming a chalazion.

Though often confused with a stye (hordeolum), a chalazion is typically non-infectious and less tender, although a large one can press on the eye and blur vision.

Common symptoms of a chalazion

• A lump on the upper or lower eyelid.
• Mild tenderness or pressure.
• Redness and swelling in the affected area.
• Sensitivity to light.
• Occasional watering of the eye.
• Blurred vision if the lump is large enough to press on the cornea.

Initial treatment options

In most cases, chalazia can be managed at home with:

• Warm compresses: Applying a warm, damp cloth to the affected eyelid for 10–15 minutes, 3 to 5 times a day, helps to loosen any blocked oil in the Meibomian glands. The warmth increases blood circulation in the eyelid, softens the hardened oils inside the glands, and promotes natural drainage. Use clean water and a clean cloth each time to avoid infection.
• Gentle eyelid massage: After using a warm compress, gently massaging the eyelid with clean fingers can help further unblock the gland and encourage the trapped material to drain out. Massage should be done in a circular motion or by pressing toward the lash line. Always wash hands before and after the massage to maintain hygiene.
• Good eyelid hygiene: Keeping the eyelids clean is essential to prevent further blockages and infections. Use eyelid wipes or a solution of diluted baby shampoo and warm water to gently clean the lash line and eyelid margins. This helps remove debris, oil, and bacteria that can contribute to gland dysfunction.
• Antibiotic or steroid eye drops/ointments: If the area becomes infected or inflamed, an optometrist or ophthalmologist may prescribe antibiotic or anti-inflammatory eye drops or ointments. These help reduce infection and swelling. It is important to follow the prescribed dosage and complete the full course of treatment as advised.

Many chalazia resolve within a few weeks using these methods. However, if there is no improvement, surgical intervention may be considered.

When is chalazion surgery necessary?

Surgical removal is typically recommended when:

• The chalazion persists for more than 1–2 months despite conservative treatment.
• The lump is large, affecting vision, or causing discomfort.
• There are signs of secondary infection or recurring chalazia.
• The lesion is cosmetically concerning to the patient.
• There is uncertainty about the diagnosis, and a biopsy may be required to rule out other conditions (e.g. sebaceous gland carcinoma).

What to expect from chalazion surgery?

Chalazion surgery is a minor outpatient procedure performed under local anaesthesia. It is quick, safe, and generally well tolerated.

1. Before the surgery

• You will be asked to stop contact lens use and avoid certain medications if advised.
• Your eye will be examined to confirm the diagnosis and plan the surgical approach.
• The procedure is usually scheduled at a convenient time and does not require hospital admission.

2. During the procedure

• Local anaesthetic is applied to numb the eyelid.
• A small clamp is used to stabilize the lid.
• The surgeon makes a small incision—typically from the underside of the eyelid (to avoid visible scarring).
• The contents of the chalazion (trapped oil and inflammatory material) are removed.
• The area is cleaned, and pressure is applied to stop any bleeding.
• No stitches are usually required.

3. After the procedure

• You may experience mild swelling, bruising, or discomfort for a few days.
• An eye patch may be placed temporarily.
• Antibiotic ointment or drops may be prescribed.
• Normal activities can usually be resumed within 1–2 days, although strenuous activities should be avoided briefly.
• Follow-up appointments ensure proper healing and to check for recurrence.

Recovery and Aftercare tips