• Eyelid problems (NHS Choices)

Chalazion

• Meibomian cyst (chalazion) is a cyst occurring within the eyelid as a result of retained meibomian secretions (inflammation of a blocked meibonian gland). Painless and often self-limiting. Usually asymptomatic but often patients present because of the uncertainty regarding the swelling.

• Differ from styes (hordeola) in that they are subacute, nontender, and usually painless nodules, does not share the angry pustular appearance. They may become acutely inflamed but, unlike a stye, chalazia usually point inside the lid rather than on the lid margin.

• Early treatment with heat and massage (Hot compresses several times/day) leads to faster resolution (resolve 2-8/52).

• Incision and curettage or intralesional triamcinolone are second line measures. Topical antibiotics are of no benefit. If the lump becomes painful, this suggests the development of an abscess (hordeolum) for which systemic antibiotics should be given.

• Meibomian cyst - chalazion (CKS)

Blepharitis

• Artificial tears, wet compresses

• Simple measures include: warm compresses, lid massage, lid cleansing of which baby shampoo can be used (1:10 warm water dilution). Only after this, if infection or dry eyes are suspected, are further treatments warranted

• 1st-line: self-care. 2nd-line:  chloramphenicol 1% ointment BD 6/52. 3rd-line (exc pregnancy/BF): oxytetracycline OR doxy

• Blepharitis (NHS Choices) / Blepharitis (CKS)

Stye

• Styes are more likely to be painful than chalazia, although the latter can be painful if they become inflamed. Styes are characterised by an acute onset and are usually of short duration (7–10 days without treatment) compared to chalazia, which are chronic and usually do not resolve without intervention.

• Infected eyelash follicle

• Hot compress ? oral Abx

• Stye (patient.info)

• Styes - hordeola (CKS)

Xanthelasma

• Yellow plaques that occur most commonly near the inner canthus of the eyelid, more often on the upper lid than the lower lid.  Xanthelasma palpebrarum is the most common cutaneous xanthoma. Around one half of these lesions are associated with elevated plasma lipid levels.