A chalazion occurs when lipid breakdown products from a meibomian gland or a Zeis gland on the eyelid leak into the surrounding tissue, which becomes inflamed. A chalazion caused by a meibomian gland will be deeper than one caused by a Zeis gland. The following steps will show diagnose a chalazion.
Instructions
1. Obtain the patient history for a chalazion. Patients often have a long history of chalazions with recent discomfort of the eyelid. They can occur at all ages but are rare in very young or elderly patients. Chalazions are more common during puberty and pregnancy because of the increase in sebaceous secretions.
2. Conduct a clinical examination of the patient. A chalazion is typically a hard, painless nodule, although there multiple nodules may be present on rare occasions. The dilated meibomian gland is sometimes visible on the underside of the eyelid and gentle pressure on the eyelid can extrude thick secretions.
3. Find chalazions most often on the upper eyelid because the greater number of meibomian glands. The patient often will have other problems with the dysfunction and obstruction of sebaceous glands. Chalazions are commonly associated with rosacea, especially when it is on the face, nose and eyelids.
4. Conduct laboratory studies of a chalazion's extrudate. It should be a mixture of inflammatory cells and large cells filled with lipids and bacterial cultures will usually be negative.
5. Take infrared photographs if needed to differentiate a chalazion from other diagnoses. The images should clearly show abnormally dilated meibomian glands along with a large amount of blocked secretions.
Tags: meibomian gland, dilated meibomian, meibomian glands, Zeis gland