The day of chalazion incision and curettage

Many chalazia shrink after weeks of warm compresses and lid cleaning. A lump does not automatically need incision. Whether to do it is decided after an examination. This page does not teach you to cut, squeeze or drain it yourself.

A chalazion is a lump after a meibomian gland blocks. It is often not very painful. A stye is an acute, painful infection. They are not the same thing. Incision is discussed when home heat has not helped and the lump remains. This page is what you feel once you are lying down.

Tell the doctor about allergies, including anaesthetics. A child needs a parent there. Do not squeeze it.

The order of the day

1. The skin around the eye is cleaned. Numbing drops come first, then local anaesthetic in the lid. A brief sting, then that area goes numb. If you still feel a sharp pain, say so.
2. The lid is held steady. You feel pressure. You are not asked to pull the lid open yourself. Holding it keeps the lid still.
3. Most are dealt with from the inner surface of the lid, partly so the skin is less likely to scar. That is not a cosmetic promise. If the lump sits against the skin, the doctor may work from the outside instead. You usually do not see a blade, and you do not need to remember how an incision runs.
4. You may feel pressure or a pull. After it is numb there should not be ongoing severe pain.
5. Bleeding is pressed on. An inner wound usually needs no stitch. The doctor may put on antibiotic ointment and a pad for a few hours. Whether to use a medicine is the doctor’s decision. A chalazion is usually not a bacterial abscess, so not everyone needs to swallow an antibiotic.
6. You can leave the same day. Swelling and a little blood-stained fluid for a day or two are common. Do not rub. How long to avoid swimming and eye make-up follows the written instruction. This page does not turn a number of days into a prescription. Whether to restart warm compresses after the wound is quiet also follows that instruction. Do not decide from the home warm-compress page.

This page does not describe how a clamp is applied, which way an incision runs, or how the contents are scraped out. Those are not steps for a patient to follow.

Diagrams

Risks and complications

No recurrence percentage. The existing page already says recurrence varies with the procedure and meibomian function, and is not your personal prognosis.

• It can come back, or a small firm spot can remain. That is more likely if meibomian dysfunction is not addressed.
• Bruise and swelling: usually fade over one to two weeks.
• Bleeding: pressure usually stops it. Further treatment is rarely needed.
• Infection: uncommon.
• A slightly uneven or asymmetric lid margin: more possible if the wound is near the lash line, or if surgery is repeated.
• A small fleshy spot on the inner conjunctiva: occasional, and a doctor may need to treat it.
• Allergy to the anaesthetic, or dizziness and sweating from anxiety.
• Injury to the eyeball or to vision: extremely rare. That is why a doctor must do this, not a squeeze at home.
• A lump in the same place that keeps returning or will not settle, especially with lash loss, an ulcer, thickening, or in an older person: the doctor may consider a laboratory test to exclude a malignant tumour. Not every recurrent lump is sent automatically. See Blepharitis, stye and chalazion. This page does not add a rule of its own.

Afterwards: which path

Expected: mild swelling, a bruise, a little blood-stained fluid, grittiness after the pad comes off.

New flashes or a clear increase in floaters, without a curtain, without sudden blindness and without severe pain: prompt ophthalmic assessment (same day if possible). This is not a typical result of chalazion surgery, but if it happens, use the same path as Floaters and retinal detachment risk.