Chalazion Removal (Eyelid Cyst Drainage)

• Incision and Curettage — Internal Approach (Standard): The eyelid is everted (turned inside out) using a chalazion clamp and held in position. A vertical incision is made through the conjunctival (inner) surface of the eyelid — directly over the cyst. The contents are evacuated using a chalazion curette and the cyst walls are scraped clean. No sutures are needed and there is no external skin scar. The clamp is removed and the eyelid is allowed to return to its normal position.
• Incision and Curettage — External Approach: Used when a chalazion is pointing towards the skin surface rather than the conjunctival side. A horizontal incision is made through the skin, directly over the chalazion, and the contents are drained. The skin wound is closed with a fine absorbable or non-absorbable suture, leaving a small scar that generally heals well and becomes barely visible.

Chalazion removal is recommended when:

• The chalazion has not resolved after 4–6 weeks of consistent warm compresses and lid hygiene.
• The chalazion is large, causing cosmetic concern or a sensation of heaviness in the eyelid.
• The lump is pressing on the eye and causing blurred vision (by distorting the shape of the cornea).
• There is no acute infection (cellulitis) at the time of treatment — if the eyelid is acutely infected, antibiotics are given first and surgery is deferred until the acute infection has settled.
• The patient prefers definitive treatment rather than waiting for possible spontaneous resolution.

Pre-procedure

A brief consultation to confirm the diagnosis and rule out any secondary infection. Any make-up around the eye is removed. The procedure is performed in the clinic or minor procedure room on the same visit if possible. It is most comfortable when it is done in a planned way in the operation theater.

On the day of the procedure

Local anaesthetic drops are applied to the eye first, followed by a small injection of local anaesthetic into the eyelid. The procedure takes approximately 15–20 minutes. Most patients experience minimal discomfort. You go home 1 to 2 hours after the procedure.

Post-procedure

Antibiotic ointment is applied and a light pad may be placed over the eye for a few hours. Mild bruising and swelling of the eyelid settle within 5 to 7 days. Most patients return to normal activities the following day.

Chalazion removal is performed under local anaesthesia as a minor office procedure. General anaesthesia is not required.

Available Options:

• Topical Anaesthetic Eye Drops: Applied first to numb the ocular surface.
• Local Anaesthetic Injection: A fine needle injection into the eyelid tissue numbs the area completely. There may be brief mild stinging from the injection, after which the procedure is comfortable.

For young children or very anxious patients, the procedure is occasionally performed under general anaesthesia.

Immediately After

Mild bruising, swelling, and redness of the eye are common and resolve within a few days. Antibiotic ointment is applied to the eye for 5–7 days. Avoid swimming and contact lens wear for 1–2 weeks.

Within the First Week

The eyelid swelling subsides and the area heals. If the external approach was used, sutures are removed at 7 days. Most patients are comfortable within 48 hours and return to work the following day.

Long-Term

The chalazion should not recur from the same gland once fully removed. However, other meibomian glands may develop chalazia in the future, particularly if underlying blepharitis or rosacea is not managed. Ongoing eyelid hygiene and warm compresses reduce recurrence risk.

• Rapid resolution: The chalazion is drained at the time of the procedure, with complete resolution of the lump typically over 1–2 weeks.
• No external scar: The standard internal approach leaves no visible mark on the outer eyelid skin.
• Same-day procedure: Performed under local anaesthesia in the clinic with early discharge.
• Quick return to normal activities: Most patients return to work and daily activities within 24–48 hours.
• Resolution of vision disturbance: Blurring caused by the cyst distorting the cornea resolves as the chalazion clears.

• Recurrence — the same lump may reform if the gland is not fully cleared; rarely, a second procedure is needed.
• Bruising and swelling, which are expected and resolve within a few days.
• Infection — uncommon with antibiotic ointment use.
• Skin depigmentation at the injection site (steroid injection only) — more visible in darker skin types.
• A small scar if the external approach is used — generally fades well in eyelid skin.