Interrelation between dry eye – blepharitis – chalazion

Dry eye develops when tear production is limited and due to this lack of moisture the eye environment is not ideal. Not only does it cause the eyes to dehydrate but it also makes them produce bad quality tears.

The tear is spread on the cornea and it consists of three layers (inner to outer): mucin (protein), aqueous (water), lipid (oil). 

  1. Mucin (protein) layer. (Produced in the conjunctiva layer and it is significantly reduced for women.)
  2. Aqueous layer.
  3. Lipid (oil) layer. (Produced in the Meibomius gland of the eyelid)

At the edge of the eyelid, the lipid and the water part of the tear are mixed together in order to lubricate the sensitive surface of the eye, which is in friction with the eyelids. 

In the case of blepharitis, the change in quality and quantity of oil available at the edge of the eyelid is so irregular that the tears produced lack oil, not properly lubricating the eye surface. This in turn induces the feeling of something strange on the eye surface and causes lacrimation. Oddly, it is common that constant lacrimation signifies dry eye. 

Chalazion is created when the oil production in the meibomian glands is done in a thick abnormal way, making the glands swallow and causing them to inflammate.

What is chalazion?

Chalazion is a small, slow-growing lump or cyst that devops within the eyelid. If not treated, it can grow significantly and affect vision. Chalazion usually develops in the upper eyelid but it occasionally develops on the lower eyelid as well. 

What causes chalazion?

The eyelid contains perpendicular glands that produce oil released by small pores behind the eyelashes. Chalazion is formed when one of these pores blocks due to increased lipid production, thicker meibomian glands , cosmetics or an inflammation. It occurs gradually over a few weeks and in some cases it may break, causing inflammation.

Chalazion symptoms

Eyelid pain and redness are symptoms of chalazion. When it develops on the lower eyelid it can be detectable by looking inside the eyelid, using  a mirror.

Risk factors

  • Chronic blepharitis
  • Eyelid inflammation
  • Acne rosacea
  • Tuberculosis
  • Viral infection

How is chalazion diagnosed?

The main symptoms that are observed to diagnose chalazion are the same as with blepharitis; usually blepharitis evolves into chalazion. More specifically:

  • Flakes on the eyelids and the infected glands
  • The possible connection of blepharitis with staphylococcus contamination
  • The possible connection of blepharitis with acne rosacea

How is chalazion treated?

Chalazion is usually treated with the same methods as blepharitis:

  1. Warm compresses
  2. Artificial tears
  3. Prescription ointments containing antibiotics and cortisone
  4. Oral tetracycline antibiotics (tetracycline or doxycycline – Vibramycin or minocycline – Minocin), in cases where chalazion is the result of serious blepharitis. The treatment isn’t based on the actual antibiotic, but on a side effect: when metabolized, antibiotics are emitted through the lipid glands, resulting in thinner discharges and subsequently in chalazion healing. 

If not improved after applying the above treatments, chalazion can either be surgically removed  or treated with a small amount of cortisone injected within.

However, studies show that in 6 months’ time, all treatment methods bear similar results. It should also be noted that post treatment a mark may stay on the eyelid.

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