For any child, having a lump on their eye, can feel so frustrating. Now, a chalazion is the most common slow growing lump in the eyelid. It usually occurs in the upper lid and more than one lump can occur at once in the same eye. Both eyes can be affected concurrently.

There are many “oil” or Meibomian glands that open out onto the edge of the eyelid. Their job is to produce oil, which lubricates the eye. If one of these glands become blocked, the oil backs up into the gland and the gland begins to swell. Occasionally, the enlarged gland can become infected or it can burst, leaking oil into the surrounding tissues resulting in inflammation and pain. If the lump becomes very large this can press on the eye and distort the child’s vision.

The cause of the blockage is often unknown, but there are several conditions that can increase the chance of developing it. These include an inflamed eyelid margin due to an infection like chronic blepharitis or skin disorders like seborrhoeic dermatitis.

Small chalazia are left to resolve on their own over a few weeks to months.

A warm compress can be placed on the affected eye for 15 minutes several times a day. This helps to remove the blockage and allow the gland to drain. The child is encouraged not to rub or squeeze their eyelids as this may introduce infection into the gland or cause it to rupture.

Anti-inflammatory and antibiotic eye drops may be required. If the eyelid has become infected, oral antibiotics might be prescribed too. If the lump persists or becomes symptomatic, the gland will need to be drained surgically. Older children can have the procedure done in the ophthalmologist’s rooms under local anaesthesia, but small children will require a general anaesthesia.

Large lumps can press on the eye and distort the child’s ability to see. This needs to be monitored carefully and in some cases, glasses may even be prescribed.

Good news to parents: On the whole, this is a benign condition that is easily treated.