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Management of marginal chalazia: a surgical approach
  1. R Dubey1,2,
  2. L W Wang1,2,
  3. E C Figueira1,2,
  4. S Amjadi1,2,
  5. T M Brown1,2,
  6. N M Younan3,
  7. G Wilcsek1,2,
  8. I C Francis1,2
  1. 1The Ocular Plastics Unit, and the Department of Ophthalmology, Prince of Wales Hospital, Randwick, New South Wales, Australia
  2. 2The University of New South Wales, Sydney, New South Wales, Australia
  3. 3North West Medical Centre, Burnie, Tasmania, Australia
  1. Correspondence to Dr Ian C Francis, Suite 12, 12-14 Malvern Avenue, Chatswood, New South Wales 2067, Australia; iancfrancis{at}gmail.com

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Chalazia are chronic lipogranulomatous inflammatory lesions resulting from the blockage of meibomian gland orifices by their complex oily secretions. Chalazia often present as painless nodules, but infected chalazia may result in preseptal cellulitis. Marginal chalazia are those located at the eyelid margin and usually result from superior extension (of a lower lid chalazion) beyond the lid margin or inferior extension (of an upper lid chalazion) beyond the lid margin.

Many treatment options exist in the literature regarding the general management of chalazia, but very little is published regarding the specific management of marginal chalazia. Marginal chalazia are frequently challenging to manage due to their location, and significant debate exists as to what constitutes best practice.

Case report

A patient in his early forties presented with a small painless chronic left lower lid margin lesion that had persisted for several months. There was no associated ulceration, telangiectasia, bleeding, tenderness or discharge. The patient described mild lower lid irritation and found the lesion cosmetically unattractive.

The clinical features were consistent with a lower lid margin chalazion.

Lower lid hygiene with bicarbonate of soda lid scrubs along with warm compresses was recommended. Oculentum hydrocortisone 2% was prescribed nocte. This management program, however, did not result in resolution of the marginal chalazion. Surgery was then performed, and this resulted in satisfactory functional and aesthetic results, evident both immediately and at 2 weeks following this procedure.

Questions

  1. What different treatment options for marginal chalazia have been described in the literature? Why should curettage be performed?

  2. Describe the technique of performing curettage on a …

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