Meibomian Cysts (Chalazion)

What is a meibomian cyst?

These cysts are common. They appear as a ‘pea’ sized hard lump in the eyelid. They cause very few problems but may be unsightly or large enough to blur your vision. Occasionally a meibomian cyst may become infected.

What causes meibomian cysts?

The eyelids have many glands helping to produce secretions to moisten your eye. Sometimes the glands producing the oily layer in the tears become blocked and the secretions trapped inside cause the lid to become inflamed and thickened. These trapped secretions form a meibomian cyst.

Patients with blepharitis (inflamed eyelids) or a skin condition called acne rosacea are more prone to get these cysts. If you have one of these conditions the doctor will advise you about treatment that may prevent you getting more cysts in the future.

Treatment

No treatment may be advised at first. Many people get better without any treatment. It can take between 2 and 6 months or more to resolve. However, if the cyst is not causing you any problems, it is often best to just watch and wait.

Hot compresses help to ease any discomfort. Hold a clean flannel, that has been soaked in hot water, gently but firmly against your closed eye (the water should be hot, but comfortable and not scalding). Do this for 5 to 10 minutes, 3 to 4 times a day. Sometimes this warmth and slight pressure is enough to soften the contents of the cyst, helping it drain more easily.

Massage of the cyst after using a hot compress can also encourage the cyst to drain. Do this gently, with a clean finger or cotton bud, in the direction of the eyelashes.

If your lump has gone or is getting much smaller there is no need for you to come to the appointment. Please telephone the hospital appointments on the following number to let us know that you will not be attending.

Tel: 0300 422 4500

If the cyst is still troublesome, a minor operation may be needed.

This will be carried out under local anaesthetic by a doctor or specialist nurse practitioner in the outpatient department. This appointment is likely to take an hour and you should not drive afterwards as the ointment used after the procedure may temporarily blur your vision. Very occasionally the eye may be padded. Please make sure that you make arrangements to get home. You can bring someone with you to the appointment if you wish.

At the appointment

We will check your vision and make a note of any medications you are currently taking (bring a list of your medication with you). We will also ask you about your general health.

Your eyelid will be examined and you will be offered an operation if needed. The procedure will be explained and you will be asked to sign a consent form to confirm that you understand and wish to go ahead with the surgery.

The operation

• Eye drops are used to numb the surface of the eye.
• Antiseptic solution will be applied around the eyelid to clean the skin.
• Local anaesthetic will then be injected around the cyst into the eyelid, this may sting a little.
• We will check that the area is numb before going ahead with the surgery.
• A small cut will be made on the inside of the lid to remove the contents of the cyst.
• No stitches are used.
• Antibiotic ointment will be put into the eye, and the eye padded.

After the operation you will be asked to sit in the waiting room for 20 minutes. The pad will then be removed, the eyelid checked and a clean pad put on if necessary.

At home

• Wash your hands before touching your eye.
• If wearing a pad which becomes loose, use some tape to re-secure it. You should not be able to blink under the pad.
• Expect to see mild blood staining on the pad when you remove it.
• Bathe the eye with cotton wool soaked in boiled, cooled water.
• Apply the antibiotic ointment you have been given 3 times a day for 5 days. This will blur your vision so do not apply it before driving.
• You may have mild discomfort 2 to 3 hours after the procedure as the local anaesthetic wears off. Take your normal pain relief to ease this.

The lid may be bruised for several weeks.

The remaining lump may take several weeks to completely disappear. Gentle massage to the area will help speed the process.

For most people a chalazion occurs just once. However, some people are prone to developing them and it may recur. You may be able to prevent it from recurring by using a hot compress on the eyelids (described above) and massaging the eyelids each morning.

Further information

More information about meibomian cysts, blepharitis and eyelid disorders such as Meibomian Gland Disease and dry eye can be found by visiting the following websites:

NHS UK

Website: www.nhs.uk/conditions/eyelid-problems/

Patient UK

Website: https://patient.info/eye-care/swollen-eyelid/chalazion

Video format advice:

Website: www.youtube.com/watch?v=PCBSur6XbYo

Contact information

If you have an urgent problem regarding your eye condition, please contact the Eye Triage to speak to a specialist nurse.

Eye Triage

Tel: 0300 422 3578

Monday to Friday, 8:00am to 1:00pm and 2:00pm to 6:00pm

Saturday, 8:00am to 1:00pm

Out of these hours your call will be diverted to the eye doctor on call to answer urgent queries only.

If you have any queries about your treatment that are not covered on this page, please ask any member of the medical or nursing staff for advice.