Can long-standing chalazia be treated without an incision? (photo)

Doctor's Answer

Conservative treatment options including warm compresses and topical anti-inflammatories, as well as intralesional triamcinolone are thought to be effective options.

Intralesional Triamcinolone is an effective treatment option for primary chalazia that is uncomplicated, and where diagnosis is not in doubt. It is probably as efficacious as incision / curettage (approximately 80-90% resolution) for primary (first occurrence chalazia) which is uncomplicated and where the risk of other pathology is low.

However, up to a third of patients require multiple injections, and the time to resolution is likely longer (reportedly between 5 - 20 days) than an incision / curettage. In addition, long-term side-effects of white deposits (triamcinolone particles) in the skin, skin hypopigmentation / depigmentation are also possible.

Less likely are steroid-related complications in the eye including raised intraocular pressure or cataract formation. However, chronic lesions which are organised are best suited for surgical removal either through an incision / curettage or in recurrent cases may also require excision biopsy. You should discuss specific options with your treating ophthalmologist!

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