Therapeutic effect of intense pulsed light on different types of chalazion in children.

This study aims to investigate the effectiveness of Intense Pulsed Light (IPL) therapy for chalazion treatment while also exploring potential variations in sensitivity among different types of chalazion. A total of 149 patients were selected to receive tobramycin combined with IPL treatment and tobramycin combined with hot compress. The treatment groups were divided into cystic type and granulomatous type according to different clinical manifestations. The course of treatment was 3 weeks. The improvement was based on the ultrasound measurement of the masses reduction of more than 50% or disappearance. In the IPL group, 17 (22.67%) cases were cured, 39 (52.00%) were effective, and 19 (25.33%) were ineffective. This includes: cystic type was cured in 3 (15.79%), effective in 5 (26.32%) cases, ineffective in 11 (57.89%) cases; granulomatous type was cured in 14 (25.00%) cases, effective in 34 (60.71%) cases, ineffective in 8 (14.29%) cases. In the hot compress group, 5 (6.76%) cases were cured, 16 (21.62%) cases were effective and 53 (71.62%) cases were ineffective. The cystic type was cured in 2 (8.00%) cases, effective in 3 (12.00%) cases and ineffective in 20 (80.00%) cases; the granulomatous type was cured in 3 (6.12%) cases, effective in 13 (26.53%) cases and ineffective in 33 (67.35%) cases. The cure rate and efficacy rate of IPL treatment is higher than that of hot compress treatment, the treatment effect of IPL treatment on granulomatous chalazion is better than that on cystic type.

Novel treatment of chalazion using light-guided-tip intense pulsed light.

We assessed the effectiveness of light-guided-tip intense pulsed light (IPL) with meibomian gland expression (MGX) in chalazion treatment. Ninety-five eyes with chalazion received a light-guided-tip IPL-MGX treatment (IPL-MGX group), and another 95 eyes with chalazion received incision with curettage treatment (Control group). Prior to IPL or incision, as well as 1 month after the final treatment, data were gathered pertaining to the lesion location and size, hyperemia, lesions regression or recurrence, and a comprehensive ophthalmic examination. The total size of the chalazia in the IPL-MGX group was significantly reduced after the final treatment, with an average resolution rate of 70.5%, which is comparable to excision surgery. A significant decrease in chalazion recurrence rate was apparent after treatment in the IPL-MGX group compared with control. Moreover, the IPL-MGX demonstrated significant advancements throughout noninvasive tear film breakup time (NIBUT) as well as meibum grade in comparison to baseline and those in the the Control group. The use of IPL-MGX was found to be an efficient therapy for reducing the size and recurring frequency of chalazia, as well as for improving the meibomian gland function. It may be considered as a first-line treatment for cases of primary or recurrent chalazia with inflammation.

The Effect of Oral Vitamin A Supplementation on Chalazion in Young Children with Vitamin A Deficiency: A Pilot Study.

Purpose: Many researchers have reported that vitamin A (VA) deficiency is related to chalazion. The purpose of this article is to clarify the effects of VA supplementation on chalazion in young children with VA deficiency. Methods: Forty-eight young children with VA deficiency suffering from chalazia were enrolled from our previous studies and were followed continuously for 1 year. Serum VA levels and recurrence of chalazion were observed. Results: The mean serum VA levels increased after supplementation (P = 2.17E-15). The mean serum VA levels of subjects who experienced recurrence were lower than those without recurrence (P = 0.015). The recurrence rate and the mean recurrent frequency after supplementation were lower than before supplementation (P = 0.01, P = 6E-6); the mean time to the first recurrence of subjects without recurrence was longer after supplementation than before supplementation (P < 0.01). Conclusions: Oral VA supplementation could reduce the recurrence of chalazion in young children with preexisting VA deficiency.

Conservative therapy for chalazia: is it really effective?

PURPOSE: To assess the within-treatment efficacy of hot compresses (HC), HC plus tobramycin (Tobrex) and HC plus tobramycin/dexamethasone (Tobradex) for chalazia treatment. METHODS: Design: Multicentre, randomized clinical trial (ClinicalTrials.gov identifier, NCT01230593). SETTING: Two clinical sites in New York and two clinical sites in Ontario. STUDY POPULATION: A total of 149 patients with one or more chalazia on separate eyelids randomly assigned to receive HC (n = 50), HC plus tobramycin (n = 50) or HC plus tobramycin/dexamethasone (n = 49). INTERVENTION: 4-6 weeks of assigned treatment. Patients were measured for chalazion horizontal width and surveyed for pain and treatment satisfaction levels. MAIN OUTCOME MEASURES: Primary outcome was complete resolution (100% size reduction). Secondary outcomes were size change in millimetres and patient reported pre- and post-treatment pain and satisfaction levels. RESULTS: In the intention-to-treat (ITT) population, complete resolution occurred in 36 (18%) lesions total, 13 (21%) treated with HC, 12 (16%) with HC plus tobramycin and 11 (18%) with HC plus tobramycin/dexamethasone, with no significant difference between them (p = .78). Individually by paired t-test, there were statistically significant post-treatment mean size differences: HC 1.20 mm (p < 0.001), HC plus tobramycin 1.69 mm (p < .001) and HC plus tobramycin/dexamethasone 1.54 mm (p < 0.001), but no significant difference between them (p = .61). Lesions that completely resolved had a statistically significant lower pretreatment duration (1.5 months) compared to lesions that did not completely resolve (2.2 months) (p = .04). CONCLUSION: Hot compresses (HC) alone or in combination with tobramycin or tobramycin/dexamethasone drops and ointment are all effective first-line treatment options for chalazia. However, physicians may consider moving directly to the use of more invasive therapies, such as incision and curettage or steroid injections, for chalazia that have been present for more than 2 months, as older lesions are less likely to resolve with conservative therapies alone.

A Case of Upper Eyelid Schwannoma

PURPOSE: To report a rare case of upper eyelid schwannoma presenting as a chalazion. CASE SUMMARY: A 54-year-old male presented to our clinic with a slowly growing, painless recurred mass located in the middle area of the right upper eyelid margin. Surgical incision had been performed on a similar mass two year previous, although no histological analysis had been performed. On examination, a 4 × 3-mm-sized, firm, nonpigmented mass was palpable in the right upper eyelid, and no signs of neurofibromatosis were present elsewhere. The lesion was initially thought to be an eyelid mass, so we performed an excisional biopsy under local anesthesia. The lesion was easily isolated from the surrounding tissue and was excised completely. Histopathologically, the excised mass showed a compact arrangement of spindle cells forming palisades with Verocay bodies (Antoni A patterns). Immunohistochemistry revealed diffuse and strong S-100 protein positivity. These findings resulted in the diagnosis of eyelid schwannoma. CONCLUSIONS: Because of its rarity and solitary feature, eyelid schwannoma can be confused with chalazion. Thus, ophthalmologists should consider schwannoma in the differential diagnosis of a slowly growing, painless recurred mass or a lesion with malignant transformation after incomplete excision.

A Case of Eyelid Sebaceoma Mimicking Chalazion

PURPOSE: To report a rare case of sebaceoma misdiagnosed as chalazion. CASE SUMMARY: A 42-year-old female presented with a visible mass in her right lower eyelid. An elevated, hard mass was located at the margin of the right lower eyelid, and she had a history of incision and curettage under the clinical impression of chalazion. On eversion of the lower eyelid, the tarsal portion of the mass was visible as a white-yellowish lesion. The mass was excised under local anesthesia. A sebaceoma was diagnosed based on histopathological examinations. Immunohistochemical studies showed positive staining results for mutator L homologue 1 (MLH1), mutator S homologue 2 (MSH2), and mutator S homologue 6 (MSH6), and she had no past medical history or family history of internal malignancy, suggesting a low possibility of Muir-Torre syndrome. CONCLUSIONS: Eyelid sebaceoma should be considered as a differential diagnosis for refractory chalazion.

A Case of Intratarsal Keratinous Cyst of the Meibomian Gland

PURPOSE: To report a patient presenting with an intratarsal keratinous cyst of the Meibomian gland in the upper eyelid and a review of the relevant literature. CASE SUMMARY: A 65-year-old male presented with a right upper eyelid mass which started 5 months prior. The patient reported that the mass recurred several weeks prior even after incision and curettage procedure. The mass was 9 x 5 mm in size and located in the center of the right upper eyelid at the level of lid crease, fixed to the tarsus and a whitish elevated focus was observed at the palpebral conjunctival surface. The mass was excised under local anesthesia and originated from the tarsus. The histopathological examinations revealed an intratarsal keratinous cyst composed of stratified squamous epithelium without keratohyalin granules and filled with keratin. The immunohistochemical studies showed positive staining results for cytokeratin 5/6, epithelial membrane antigen, and carcinoembryonic antigen. CONCLUSIONS: Intratarsal keratinous cyst of the Meibomian gland should be considered as a differential diagnosis of a recurrent tarsal mass.

Ocular demodicidosis as a risk factor of adult recurrent chalazion.

PURPOSE: To report Demodex infestation in adult recurrent chalazion and its clinical response to weekly lid scrub with 50% tea tree oil (TTO) and daily lid scrub with tea tree shampoo. METHODS: This is a retrospective review of 30 adult patients (48 eyes) who presented with recurrent chalazion within 6 months after conventional treatment. Demodex was detected by random lash sampling and microscopic examination. Patients with confirmed ocular Demodex infestation were treated with weekly lid scrub with 50% TTO and daily lid scrub with tea tree shampoo. The study is limited by the lack of a control group. RESULTS: The mean age of patients was 39.1 ± 10.2 years (range 18-69). The mean follow-up of patients is 10.0 ± 3.0 months (range 6-24 months). Among 48 eyes with recurrent chalazion, Demodex mites were found in 35 (72.9%). Recurrent chalazion was found to be associated with ocular demodicidosis (Fisher exact test, p = 0.017). Tea tree oil treatment was given to 31 eyes with recurrent chalazion associated with Demodex infestation. Among the treatment group, all cases except one had no recurrence after the TTO treatment. The success rate of preventing recurrence is 96.8%. Treatment of TTO was found to be associated with preventing recurrence of chalazion associated with Demodex infestation (Fisher exact test, p = 0.002). CONCLUSIONS: The possibility of demodicidosis should be considered in adults presenting with recurrent chalazia. Tea tree oil eyelid scrubs is an effective treatment in preventing recurrence.

Comparison of topical lidocaine [2% gel] and injectable lidocaine [2% solution] for incision and curettage of chalazion in Ilorin, Nigeria.

AIMS AND OBJECTIVES: To compare the efficacy and side effects profile of topical 2% lidocaine gel with injectable 2% lidocaine solution as local anaesthetics for incision and curettage of chalazion. PATIENTS AND METHODS: Overa 12 month period, 61 patients with unilateral chalazia who were scheduled for incision and curettage surgery under local anaesthesia were randomized into 2 groups: A & B. Group A received 1.5 ml of injectable lidocaine as local anaesthetic while Group B received 1.5 ml of lidocaine 2% gel topically. The major outcome of interest was pain experienced during anaesthetic administration and surgery. RESULTS: Mean pain score from anaesthesia administration was significantly higher in the injection group (A = 4.46 vs. B = 0.57), (p = 0.000005). There was a statistically significant difference in mean pain score during incision and curettage with more pain in the gel group (A = 2.84 vs. B = 4.83), (p = 0.0012). However, the mean total pain score (surgery plus anaesthesia) was more in the injection than the gel group (A = 7.3 vs. B = 5.4) (p = 0.0094). The proportions that had no fear for injection were 54.8% in A and 56.7 % in B. Group A had significantly more ptosis than Group B (2.2 vs. 1.4, p = 0.00003,). Bleeding occured in 93.5% in group A while none occurred in Group B (p = 0.000). CONCLUSION: Lidocaine 2% gel is an effective, safe and convenient alternative to injectable lidocaine 2% as local anaesthetic agent in incision and curettage for Chalazion in this study.

A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses.

BACKGROUND: Three methods of treating chalazia were compared: intralesional triamcinolone acetonide injections (0.2 mL of 10 mg/mL), incision and curettage and advice regarding the application of hot compresses to the affected eyelid. METHODS: This was a single centre randomized treatment study. Patients with a chalazion underwent either of the three treatment options. Chalazion resolution, pain, satisfaction and inconvenience experienced because of treatments were the outcomes assessed via a telephone interview at 3 weeks. RESULTS: 136 consecutive patients were enrolled into the study. At the 3-week follow up, the resolution rates in the triamcinolone acetonide injection and surgical treatment groups were not significantly different from each other at 84% (47/56) and 87% (39/45), respectively (P < 0.001), but was significantly lower in the conservative treatment group at 46% (16/35) (P < 0.001). Pain scores were higher in the surgical treatment group compared with the triamcinolone injection group (P < 0.003). Inconvenience experienced by patients was reported as significantly less in the triamcinolone group compared with the conservative and surgical treatment groups (P < 0.001). Patient satisfaction scores were lower in the conservative treatment group compared with each of the other two groups which in turn, were no different from each other regarding this outcome (P < 0.001). CONCLUSIONS: To our knowledge, this is the first prospective randomized study comparing the three methods of chalazia treatment. Results suggest that a single triamcinolone acetonide injection followed by lid massage is almost as effective as incision and curettage in the treatment of chalazia and with similar patient satisfaction and less pain and patient inconvenience.

Dilated examination of patients referred with minor lid complaints--is it necessary?

OBJECTIVE: To evaluate whether dilated fundus examination is necessary on patients presenting to clinic with lid complaints and normal vision. METHODS: Patients with lid complaints were recruited from general and emergency clinics. Patients with visual symptoms or previous ophthalmic history were excluded. Subjects were examined by a junior ophthalmologist with slit-lamp biomicroscopy and Goldmann tonometry. Dilated posterior segment examination was performed with a Volk lens and the peripheral retina was examined with a three-mirror contact lens. RESULTS: A total of 100 patients (200 eyes) were recruited, 63 females and 37 males with an average age of 45 years (SD of 19 years). The majority of lid abnormalities were chalazia (66) and papilloma (21). Posterior segment findings were early cataracts in five cases (eight eyes), macular drusen in three cases (five eyes), peripheral retinal lattice degeneration in two cases (three eyes), retinal pigment epithelial changes in one case (two eyes), a choroidal naevus in one eye, choroidal atrophy in one eye, and one case with asymmetric disc cupping. Six patients were seen by senior ophthalmologists and all were discharged after the first visit. CONCLUSIONS: In our sample of 100 patients presenting with lid complaints and normal visual acuity, dilated examination revealed no sight-threatening conditions that required further treatment or regular follow-up. Therefore, a single episode of screening for nonspecified retinal disease in a group with no particular risk factors is an inefficient screening method.

[Treatment of benign eyelid conditions with Argon laser]. / Traitement des affections palpébrales bénignes au laser à Argon.

Eyelid surgery is not always uneventful. Complications (punctal ectropion, retractile scars) can sometimes occur. Argon laser treatment is an interesting alternative technique, particularly in cases with cosmetic indications. The advantages of the procedure, compared to surgery are numerous: magnified view of tissue removal, enhancing complete excision; good hemostasis, avoiding wound sutures and bandage; fast and painless technique; outpatient office procedure with little post-operative care; good acceptance of the technique by most of the patients. The technique and the main indications are described in this paper.

Homeopatia y oftalmologia: el chalazión / Homeopathy and oftalmology: chalazion

Se realizó una revisión de la Materia Médica Homeopática, buscando los medicamentos que se adaptan al cuadro clinico de los pacientes con diagnostico de chalazión, desde un nivel de similitud local. Se senala...

Homeopatia y oftalmologia: el chalazión / Homeopathy and oftalmology: chalazion

Se realizó una revisión de la Materia Médica Homeopática, buscando los medicamentos que se adaptan al cuadro clinico de los pacientes con diagnostico de chalazión, desde un nivel de similitud local. Se senala... (AU)

Minor surgery: an extended role for ophthalmic nurses in the United Kingdom.

This article discusses the reasons for extending the scope of ophthalmic nursing practice in the Princess Alexandra Eye Pavilion, Edinburgh, Scotland, particularly with regard to the ophthalmic nurses' role and management of meibomian cysts (chalazions) through minor surgery to the eyelid. The article describes how the in-service teaching program was established in the hospital for those ophthalmic nurses who were interested in developing their knowledge and practical surgical nursing skills to undertake the management of meibomian cysts. The appropriate legal and ethical aspects of patient care involved in extending the scope of practice in the United Kingdom are discussed, including accountability and duty of care.