My chalazion isn't going away, do I need a surgery?

I have been conservatively treating chalazia (or more technically meibomian gland cysts) for many years using intralesional corticosteroid injections of varying concentrations depending upon the size of the cyst. These cysts usually shrink dramatically after only one or two sessions spaced a month apart.On the rare occasion that a chalazion does not respond or respond sufficiently well, I have used light electrocautery, under local anesthetic, to the center of the cyst, which usually shrinks it entirely and leaves a nearly imperceptible mark. Although it seems that treating something like this so close may be cause for hesitation, over the years, even my most squeamish patients have been forced to admit that the treatment, which takes about three minutes to perform, is nearly painless.

Very often the steroid injection will cause the chalazia to melt and disappear.  It can take 6 weeks and sometimes a second round of steroids is needed.  Taking this approach, many of these lesions do not need surgery.

A chalazion is a small lump in the eyelid due to a blocked meibomian gland, usually in th prescience of posterior blepharitis or meibomian gland dysfunction. At last 30% go away spontaneously with either no treatment or light medical treatment with hot spoon, injected steroid or topical steroid ointment. It is often worth waiting a few weeks before considering eyelid surgery (incision and curettage) to see if it gets better on its own. If it is interfering with vision, id unsightly, then incision and curettage early is recommended.If it does persist, please show to your Oculoplastic surgeon for advice on management.