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Paediatric Chalazion

A chalazion is a harmless cyst caused by a blocked meibomian gland in the eyelid. Meibomian glands in theeyelid produce an oil which helps keep the eye moist. If the gland becomes blocked, the oil builds up into a cyst which looks like a small lump in the eyelid. The lump can become irritated and red and, occasionally, infected.

What causes them?

Lid cysts are common, especially in children. If children develop cysts repeatedly, they could have blepharitis, a long-term mild irritation of the edge of the eyelids, which is usually harmless but occasionally affects the eye.

Treatment of chalazion

Most cysts disappear with time but can take weeks and sometimes many months, to go. They are normally harmless and can be safely left to get better with time in most cases.

Warm compresses might speed up the disappearance of the cyst. Use clean cotton wool or a clean flannel soaked in very warm water (be sure it’s not hot enough to burn). Squeeze out excess water and place the flannel or cotton wool on your child’s closed eyelids over the cyst for two minutes at a time twice daily.

Occasionally, the doctor will prescribe a short course of antibiotic ointment or drops to help any irritation and, if there is infection spreading from the cyst, will prescribe antibiotics by mouth. However, medication does not cause the cysts to disappear.

Surgical treatment

If there is a large cyst which remains for a long time, it is possible to perform surgery to remove it. In most cases, surgery is not medically necessary but can be done to speed up healing of the cyst. However, surgery is often not recommended because:

  • The cyst is harmless and will disappear with time.
  • Surgery does not prevent another cyst from developing.
  • There is a 1 in 5 chance the cyst will regrow.
  • There are rare, but serious risks of surgery such as infection or scarring.
  • For many children, it requires a general anaesthetic which carries a small risk to their general health.

What to look out for

  • Increasing redness and soreness of the eye itself
  • Very blurred vision
  • Very noticeable and spreading redness together with a lot of swelling of the eyelid.

If the cyst has been there a long time and you would like your child to be considered for surgery, please ask your GP to refer your child to the clinic.

video transcript
To clean the eyelids the first step is to do a warm compress which softens the debris on the eyelids making it easy to clean off.
Place a clean face cloth under a hot tap, nice and hot but not hot enough to burn or be uncomfortable. Wring it out and hold the hot compress on top of the closed eyes for one or two minutes.
If the cloth becomes cool, warm under the tap again, wring and replace it on the closed lids.
Next we perform the cleaning for older children we use a moistened cotton pad. This can be moistened in warm tap water or by using a weak solution of baby shampoo or bicarbonate of soda.
Squeeze out any excess moisture.
First you clean the back edge of the eyelid. Pull down the lower lid and run the bud firmly but gently along the thin line of skin behind the lashes four or five times.
 Do the same for the top lid putting it up and away from the eye. Then we clean the lashes. For the top lid, close the eyes firmly and scrub vigorously at the base of the lashes doing a small part of the lid at a time and moving gradually along the width of the lid to do all the lashes.
In the same movement to use for brushing your teeth. Then open the eye, look up and repeat with the bottom lid lashes, again moving gradually along the lid to ensure all the lashes are clean.
Ideally older children should be taught to do this themselves.
For younger children we start again with a warm compress.  Then use a face cloth to clean the lid edges moistened in warm tap water or with a weak solution of baby shampoo or bicarbonate of soda.
After moistening wring out the cloth wrapped the cloth tightly around the index finger so it covers the length of the finger holding the rest of the cloth in the hand.
With the child's eyes gently closed lay the finger with the length of the cloth along the lashes apply gentle pressure towards the eye and wipe up in a sweeping motion two to three times to clean the upper lid.
The gentle pressure towards the eyes will allow the eyelids to turn out a little so that the back edge of the eyelids are cleaned. Then wipe down two or three times in the same way to clean the lower lid.
To clean the base of the lashes; with your child's eyes tightly closed use the length of the the finger covered by the cloth to rub quite vigorously along where the lashes come out at the skin moving along the eyelids so that all areas are cleaned.

Richard Desmond Children's Eye Centre A&E

The Richard Desmond Children's Eye Centre is our dedicated children's hospital. It is based on the same campus as the main hospital in London's City Road, but has a separate entrance in Peerless Street.

 

Richard Desmond Children's Eye Centre, Moorfields Eye Hospital.

3 Peerless Street

London

EC1V 9EZ

 

Opening hours: 9am - 4pm, Monday to Friday.

Outside of these hours, please attend the adult A&E department at Moorfields City Road (around the corner).

 

Call 0207 253 3411

Author: Paediatric information group

Review date: January 2020