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How do you know whether you need medical or surgical treatment for your chalazion (eyelid lump)?

Many patients ring us at Clinica London to ask whether they need to have that chalazion operated on. They have often looked it up on the internet, particularly on YouTube, and from what they have seen they are not sure whether their lump is going to be suitable for surgery or not. In general, I would say that if your chalazion is relatively new – that is, you have only had it for one to two weeks – then you should try and treat it medically. There is a very good chance that it will go away spontaneously with good medical treatment in this case. However, be careful about warm compresses when the chalazion is very inflamed: sometimes they seem to make it worse, bringing the inflammation forward into the eyelid and making it more difficult to treat later.The mainstay of treating an early chalazion is to clean the eyelids exceedingly well several times a day, to do very light warm compresses and to use some antibiotic ointment. If the lump is particularly inflamed then you may have to see your general practitioner or come in to see me or one of my colleagues, such as Mr Sajjad Ahmad or Ms Laura Crawley, here at Clinica London, for a course of antibiotics.Once we are sure that the lump is persisting and that it is a fully formed chalazion then it is probably suitable for surgery. Having said that, I will sometimes see a patient who has had their chalazion for more than two or three weeks, perhaps for several months, and it has been waxing and waning with inflammation, then becoming quieter and then large and inflamed again. I will not operate whilst it is very inflamed; instead, I like to prescribe a small course of topical antibiotic and steroid ointment and give you some instructions on eyelid cleaning for a few days. If it is very inflamed, I will give you a course of oral antibiotics for five to seven days and then, when the inflammation has subsided, I can safely and effectively carry out the surgery – the incision and curettage of your chalazion. If you are in any doubt as to whether you need medical or surgical treatment for your eyelid lump, please call us at Clinica London and arrange to see one of the ophthalmologists, such as myself, Miss Jane Olver, Mr Sajjad Ahmad, Mr Jaheed Khan or Dr Laura Crawley.

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