eMedicine Specialties > Emergency Medicine > Ophthalmology

Chalazion: Follow-up

Author: Jane Lee Fansler, MD, Resident Physician, Stanford University/Kaiser Permanente Emergency Medicine Residency Program
Coauthor(s): Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center; Sally Santen, MD, Program Director, Assistant Professor, Department of Emergency Medicine, Vanderbilt University
Contributor Information and Disclosures

Updated: Apr 22, 2009

Follow-up

Further Outpatient Care

  • Advise patients to obtain follow-up care with an ophthalmologist if the chalazion does not resolve, has a recurrent episode, or additional symptoms develop.

Deterrence/Prevention

  • Classic or typical chalazia do occur with more frequency in patients with immune disorders or acne rosacea and in individuals who have high UV exposure. Medical management of these medical conditions and limiting UV exposure by using sunglasses and hats can theoretically reduce chalazion formation.
  • Daily eyelid hygiene can help prevent ductal blockages.
  • Using antidandruff shampoo on the eyebrows can lessen the occurrence of skin particles causing blockages, especially in those prone to seborrhea.

Complications

  • Potential complications of chalazia are cosmetic deformity and infection, including development of hordeolum or preseptal cellulitis.
  • Complications of improper drainage are disruption of lash growth, lid deformity, and lid fistula.
  • Visual disturbances can occur with large chalazia.
  • Recurrences of chalazia are not uncommon. Potential malignant causes of ductal blockage should especially be addressed in these cases.

Prognosis

  • Most chalazia resolve on their own. Conservative management aids in the resolution.
  • Recurrences are not uncommon, especially in those with predisposing skin conditions.
  • Some specialists recommend biopsy and drainage of all chalazion, primary or recurrent. Specimens should be submitted for histopathologic examination.

Patient Education

  • Instruct patients regarding proper use of warm compresses.
  • Avoid draining or popping the chalazion.
  • For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education articles Chalazion (Lump in Eyelid) and Sty.

Miscellaneous

Medicolegal Pitfalls

  • A chalazion is not an emergency medical condition; however, the emergency physician should refer the patient to an ophthalmologist for definitive examination and treatment.
  • Applying a warm compress to the chalazion may be satisfactory for the emergency department treatment.
  • Recurrent chalazion, missed diagnosis of conditions that masquerade as chalazion, inadvertent corneal perforation, and exacerbation of viral or bacterial infection are risks when the emergency physician assumes primary care responsibility for the chalazion.
 
Acknowledgments




More on Chalazion

Overview: Chalazion
Differential Diagnoses & Workup: Chalazion
Treatment & Medication: Chalazion
Follow-up: Chalazion
Multimedia: Chalazion
References
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References

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Further Reading

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Contributor Information and Disclosures

Author

Jane Lee Fansler, MD, Resident Physician, Stanford University/Kaiser Permanente Emergency Medicine Residency Program
Jane Lee Fansler, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, Emergency Medicine Residents Association, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Coauthor(s)

Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Disclosure: Nothing to disclose.

Sally Santen, MD, Program Director, Assistant Professor, Department of Emergency Medicine, Vanderbilt University
Sally Santen, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Medical Editor

David FM Brown, MD, Assistant Professor, Department of Medicine, Division of Emergency Medicine, Harvard Medical School; Associate-Chief, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital
David FM Brown, MD is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine
Disclosure: Schering  Honoraria Speaking and teaching

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Douglas Lavenburg, MD, Clinical Professor, Department of Emergency Medicine, Christiana Care Health Systems
Douglas Lavenburg, MD is a member of the following medical societies: American Society of Cataract and Refractive Surgery
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP, Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, University Hospitals, Case Medical Center
Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

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