Why is a steroid shot for chalazion not commonly offered as a treatment?

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. It is certainly a viable option for patients who would prefer the idea of an injection without the physical removal of the chalazia, if they meet the treatment criteria for suitable lesions, and are aware of the possible complications associated with this treatment option.

Do consider asking your treating ophthalmologist in future if this is an option that strongly appeals to you!

ESG

The advantages of a steroid shot are that it is quicker, requires no special instrument during the procedure, is less painful than incision and drainage, and does not require dressing. It is also more suitable for patients who are allergic to local anaesthesia.

However, a disadvantage of steroid shots is that many patients would require a second injection. In some cases of chalazion, such as patient with a lid inflammation (blepharitis), they may require multiple injections.

Possible secondary complications include ocular penetration, increase in intraocular pressure, visual loss, and skin pigmentation, especially in dark skin individuals.

If you are more comfortable with the idea of a steroid shot (as compared to an incision), do visit your eye doctor for a consultation, and discuss which treatment options is more suitable for you.