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Eyelids and tear film · C

Incision and curettage of a chalazion

Conjunctival-side incision

Last reviewed: 2026-10-03 · 潘家健醫生

Key points

  • Chalazion incision and curettage is usually a day-case procedure via the conjunctival side — consent points, not a DIY cut.
  • Do not squeeze; warm compresses before/after follow the doctor’s advice.
  • Recurrent lumps with ulceration, lash loss or in older adults may prompt pathology to exclude sebaceous carcinoma — not every recurrence is sent automatically.
  • Marked lid redness and pain, fever, vision affected or a rapidly growing lump: see a doctor promptly; if severe: 999 / A&E.

If a doctor recommends incision, consent may cover the steps below. Many chalazia shrink with weeks of warm compress and lid hygiene — not every lump needs surgery.

The order of the day, and the diagrams, are on The day of chalazion incision and curettage. The lines below are consent points, not instructions to cut or squeeze it yourself.

These steps are what a doctor may explain for informed consent — not instructions to cut or squeeze the lump yourself. Whether to operate, and how, can only be decided in person.

Steps

  1. Clean the lids; topical then subcutaneous local anaesthetic (often a lidocaine-class agent — mention allergy)
  2. A chalazion clamp holds the lump, reduces bleeding and keeps the curette away from the globe
  3. Usually a small vertical cut on the conjunctival (inner lid) side; one aim of a conjunctival incision is to lower skin-scar risk — not a cosmetic guarantee. A skin cut may be used if the lump is more anterior
  4. Curette out the granuloma contents; the doctor may try to clear contents and wall as far as practical. Recurrence can still happen — not a guarantee
  5. Pressure for a few minutes; the conjunctival cut is usually left unsutured
  6. Antibiotic ointment ± a pad for a few hours

Aftercare always follows the treating doctor’s written instructions; the lines below are common education ballparks only: use ointment as directed; swelling and a little oozing for a day or two are common, and intermittent cold compress may be suggested. Avoid rubbing, swimming and eye make-up for about a week (follow your doctor). Whether to restart warm compress and massage once the wound is quiet — follow instructions. Children need a parent’s help; do not squeeze the lump yourself.

Other options a doctor may discuss

  • Warm compress and lid hygiene first, especially with meibomian dysfunction
  • Intralesional steroid in selected cases (IOP rise, skin thinning or pigment change)
  • Oral or topical antibiotic is not automatic — a chalazion is usually a sterile granuloma

Published risks

  • Recurrence varies with technique and meibomian status; higher if meibomian dysfunction is untreated
  • Bruise and swelling: usually 1–2 weeks
  • Bleeding: pressure usually suffices
  • Infection: uncommon
  • Lid notching or mild deformity if the cut is near the margin or surgery is repeated
  • Pyogenic granuloma: occasional
  • Residual lump if the wall is left
  • Globe perforation: extremely rare — hence the clamp
  • Anaesthetic allergy or a vasovagal faint
Lid redness with severe pain, fever, affected vision, or a lump that enlarges quickly: do not rely on warm compress or squeezing alone — see a doctor promptly; if you cannot get there yourself or it is severe: call 999 / go to A&E.
A recurrent or atypical lump with ulcer, lash loss or thickening — especially in older people — may need pathology. Not every recurrence is automatically sent.

This is general medical information, not a diagnosis, and cannot replace an in-person consultation with a registered ophthalmologist, refraction, or a dilated fundus exam. It is not advice to use any medicine or undergo any procedure. Medicines (including off-label use), laser or surgery must be decided by a registered doctor after examination, according to indications and Hong Kong registration. Figures from the literature are published averages, not any clinic’s results. This site does not book, prescribe or refer. Do not change treatment on your own.