Abstract
Purpose :
Chalazion is a common condition characterized by lipogranulomatous inflammation arising from noninfectious obstruction of meibomian glands in the eyelid. While chalazia are considered sterile lesions, they are frequently associated with blepharitis and hordeola and may become secondarily infected with bacteria of the ocular surface. Other benign or malignant lesions of the eyelids are frequently misdiagnosed as chalazia. We aimed to evaluate the microbial and histopathological profiles of excised tissues obtained from patients treated in a clinic specialized in evaluation and management of chalazia.
Methods :
We retrospectively reviewed the records of patients referred for evaluation in chalazion clinic, a twice-weekly procedure clinic at a large academic medical center, between December 2022 and December 2023. Patients with a presumed diagnosis of chalazia were referred directly to this clinic for evaluation and management. Culture and histopathological results from excised tissues were reviewed to evaluate associated organisms and tissue diagnoses.
Results :
Of the 676 patients scheduled for evaluation in chalazion clinic, 575 patients were seen in the clinic. Mean age of patients evaluated was 43.7 years (range, 17 to 88 years), and 321 patients were female (56%). Incision and drainage (I&D) was performed in 435 patients (76%), while medical management with warm compresses, topical antibiotic/steroid ointment and/or oral antibiotics was pursued in 140 patients (24%). Of the 18 samples sent for culture, 10 grew coagulase-negative staphylococcus. Other organisms identified included Cutibacterium (C.) acnes (n=4), staphylococcus (S.) aureus (n=2), Bacillus species (n=1), and normal flora (n=2). Twenty-nine samples were sent for anatomic pathology evaluation. Non-chalazion diagnoses identified included pyogenic granuloma (n=3), seborrheic keratosis (n=3), papilloma (n=2), conjunctival amyloidosis (n=1), basal cell carcinoma (n=1), endocrine mucin-producing sweat gland carcinoma (n=1), fibroma (n=1), and hidrocystoma (n=1).
Conclusions :
The most common bacteria identified on cultures from chalazion I&D was coagulase-negative staphylococcus, followed by C. acnes and S. aureus. Histopathological analysis revealed multiple other tissue diagnoses for lesions initially diagnosed as chalazia. These findings have implications on the diagnosis and treatment of chalazia.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.