Eyelid cyst (chalazion): why does it come back, and how is it treated?

Many patients complain that an eyelid cyst (chalazion) comes back even after it has been removed surgically. To understand why, we start with what a chalazion is.

What is a chalazion?

The oil glands in the upper and lower eyelids produce an oily substance that mixes with the tears and prevents them from evaporating. When the opening of one of these glands becomes blocked, a chalazion forms.

Why does a chalazion come back?

Dr. Mahmoud El Samkary explains that the three most common causes are:

1. Vitamin A deficiency: especially in people who do not eat enough vegetables.
2. Poor vision: not wearing glasses regularly, or needing a new prescription.
3. Poorly controlled diabetes.

There is no relation between eyelid cysts and the amount of fat in the body.

Complications of a neglected chalazion

• Bacterial infection of the cyst.
• Rupture of the cyst into the conjunctiva, forming a granuloma.
• Enlargement that presses on the cornea, causing astigmatism.

Treatment

Treatment starts with medication. If it does not improve, the cyst is removed surgically under local anesthesia through a small internal incision with no external scar. The eye patch is removed after about 6 hours, and the patient returns to work the next day. Most importantly, the cause must be treated so the chalazion does not come back.