Incision and Curettage of Chalazion

Incision and curettage of chalazion

A chalazion is a chronic non-inflammatory condition of the meibomian glands present in the eye. Large size chalazion may affect the cornea and affect the vision. Incision and surgical curettage of chalazion are required when the patient does not respond to non-invasive treatment. It helps avoid potential complications and cosmetic deformities that may be due to untreated chalazion.

Incision and surgical curettage of chalazion are performed in the following indications:

1. Chalazion unresponsive to conservative and non-invasive treatment
2. Large chalazion
3. Multiple chalazia
4. Chalazion that interferes with the vision 

Incision and surgical curettage of chalazion is a preferred method when chalazion does not respond to other treatments, and the patients have progressing symptoms. An untreated chalazion may result in several complications, some of which may be permanent. Some of the conditions that may result due to delayed surgery are:

1. Preseptal cellulitis leading to disfiguring lid with progression
2. Visual disturbances (if the chalazion is in contact with the cornea)
3. Increased corneal aberrations and astigmatism
4. Pain and fever

1. Inform your doctor about the medications that you are taking, including prescription drugs, over-the-counter medications, herbal products and vitamin supplements.
2. Provide information to the doctor if you snore or have obstructive sleep apnea. Having these conditions increases the risk of anaesthesia side effects.
3. The doctor may recommend you avoid smoking or drinking prior to surgery.
4. Inform the doctor if you have any prior complications with anaesthesia.
5. You may also be advised to remove the nail pains as the colour of the nail beds indicates the circulation or pulse while the patient is under anaesthesia.
6. The staff will also provide information about your eating and drinking schedule before the surgery. 

You may expect the following before the surgery:

1. Your doctor may advise you to take your regular medications.
2. As the procedure is done under anaesthesia and you may be discharged on the same day, you may accompany someone to drive you back home.
3. You or your relative need to sign the consent form and complete other formalities at the hospital.
4. You would undergo a comprehensive checkup to determine your fitness to undergo surgery.
5. The staff will ask you to wear a hospital gown.
6. You would be taken to the operation room for surgery.

What is the procedure for Incision and curettage of Chalazion?

The doctor will perform the procedure in the following steps:

1. The surgery takes around 15-30 minutes to complete. The cost of the surgery is around Rs 1000 to Rs 5000 depending upon the hospital, consultation charges, mediations, and length of recovery.
2. You will be asked to lie in the supine position (lying on the back with your face upwards).
3. Both the topical and injectable forms of anaesthesia are used by surgeon. He may instil the eye drop and inject the anaesthetic agent below the orbicularis muscle.
4. A chalazion clamp is inserted that helps in the localization of the lesion and controls bleeding. The conjunctiva area is surrounded by a circular part of the clamp, while the blade area lies on the skin.
5. An incision is made on the chalazion with precautions to avoid any lid margin incision.
6. A curette in the incision is inserted, and the cyst is scrapped. The doctor may send the scrapped tissue for pathological examination to rule out the presence of sebaceous gland carcinoma. 
7. The doctor opens and inspects the wound and removes any tags of tissues with the help of forceps until all the chalazion content is removed.
8. The clamp is removed and the pressure is applied until the bleeding stops. 
9. The clot is wiped from over the wound. The doctor also applies topical antibiotics.

You may expect the following after the surgery:

1. You may be discharged from the hospital on the day of surgery.
2. The incision of the surgery would be healed within 7-10 days.
3. The patient must avoid any activity that increases the risk of eye injury for at least 2 weeks.
4. Wearing contact lenses should be avoided for a week and eye makeup should be avoided for at least one month after the surgery. 
5. Certain medications, that reduce the risk of infection and manage pain and inflammation, are prescribed. 
6. Antibiotics, steroids and lubricants are generally prescribed for one week. 
7. The patient is also advised to apply the cold compress for 48 hours. Thereafter, the hot compress is applied multiple times a day.
8. The patients should adhere to lid hygiene measures.
9. There would be no instant disappearance of the chalazion. It will gradually reduce in size and may take a few weeks to shrink. Post-surgical symptoms like bruising and swelling may heal within a few weeks.

The doctor will advise the patient to visit the hospital for follow-up. During the follow-up, the doctor will evaluate the healing process and determine any surgical complications. The doctor may either discontinue or reduce the dose of medications.

Consult the doctor if you experience any of the following symptoms:

1. Any change in vision
2. Recurrence of chalazion
3. Bleeding
4. Fever and pain
5. Bruising or swelling around eyelids that generally disappears within few weeks
6. Eyelid infection, which may require antibiotic administration
7. Permanent mark and scarring on the eyelid