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		a chalazion that has been present some time (best having minor surgery)
	acute chalazion needing hot bathing and antibiotic cream (possibly tablets as well)     a recent acute chalzion: this is likely to settle without surgery

Recurrent chalazions: prevention

If you develop chalazions quite frequently, preventative treatment may be helpful see. Chalazions may be caused by blockage and infection of the glands in the eyelids. Some people who develop frequent chalazions have dry skin, with secretions blocking the glands. Treatment that unblocks the glands in the eyelid may help stop more chalazions developing. To prevent the glands blocking, (see blepharitis page) clean the eyelids each day. Soak some cotton wool in warm water. Rub the cotton wool over the closed eyelids for 2-3 minutes, and repeat. Then clean the edge of the lower eyelid with a cotton bud to remove scales and debris on the edge of the eyelid. Gently rub the cotton bud along the eyelid, using a mirror, and pulling the lid away from the eyeball with the fingers of the other hand. It is safer to boil the water first to sterilise it, and allow it to cool. When the lid is clean after a couple of weeks, It is safe to stop cleaning, but you may need to start again if chalazions start to develop again. Adding bicarbonate to the water can help. Use a teaspoon of baking soda (sodium bicarbonate) in a pint of boiled water: this solution can be used over a week if refrigerated. If the cleaning is not helpful preventing the chalazions, antibiotic ointment may help. Your GP will need to prescribe it; try it for 3 months (chloromycetin or fucithalmic). A healthy diet with omega 3 (or flaxseed oil) and plenty of vegetables and fruit, with little saturated and transfats, is very important. Sometimes chalazions return once the ointment is stopped, and you may need a repeat prescription from your GP. Some people benefit using the cream intermittently. Finally, if all else fails and you still develop more chalazions, a course of antibiotic tablets may help, such as oxytetracycline 250mg twice daily for three months (from your GP). This treatment is sometimes useful if the other treatments do not work. It is particularly effective if you have a skin condition, such as acne rosacea, or very dry skin, or if the edge of your eyelid stays red with many scales. Antibiotic tablets are NOT suitable for everyone, particularly if you use several other tablets or have stomach problems. You will need to discuss this treatment with your GP first. Oxytetracycline 250mg twice daily (or doxcycline 50mg once daily [or erythromycin]) is usually used for 3 months. The benefit of antibiotics lasts several months after stopping treatment, but if the condition returns you may need to use further courses. Excellent article for BMJ subscribers    BJO 2011

These are tiny cysts with fluid inside. They do not grow. After a local anaesthetic injection, a small nick is made in the cyst. The skin of the cyst is also removed. Usually they do not recur.

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