A 35-year-old man presents with a unilateral painless upper eyelid swelling of 3 months duration. Examination shows firm, nontender nodule in the tarsal plate, with granulomatous material on eversion. The lid skin is unaffected. The most appropriate management is:
- A Incision and curettage through the conjunctival surface under local anesthesia ✓
- B External skin incision with chalazion excision
- C Intralesional triamcinolone injection as the sole treatment
- D Oral doxycycline 100 mg BD for 4 weeks
Explanation
A chalazion is a chronic granulomatous inflammation of a meibomian gland (lipogranuloma from retained meibomian secretions). The standard treatment is incision and curettage (I&C) through the conjunctival surface (vertical incision in the tarsal plate to protect the tarsal architecture) under local anesthesia — this avoids skin scarring. Intralesional steroid (triamcinolone) is used for small or recurrent chalazia as an alternative to surgery, or as adjunct. External skin approach is used only when pointing through the skin. Oral doxycycline helps underlying meibomian gland dysfunction (rosacea-associated) to prevent recurrence but doesn't treat the existing chalazion.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.