So today my facility went on a health screening program, we visited a remote village on the outskirts of Kumasi to provide free health services to the indigenous of the town. It was as exciting as outreaches have always been, being away from the hospital environment and going to the patient's location, well you see a lot and learn a lot.
For the area we visited today, the prevailing conditions were allergic reactions due to the dusty environment and the nature of the road. There was however a condition that was brought in by a woman which I thought I'd talk about it with my dear readers today. So as usual, I do hope that you enjoy the read and that you have a fun time.
Chalazion
So my patient presented with localized swelling of the upper eyelid, somewhere in the middle of the lid, not so close to the margin and when I asked her about pains she said it doesn't hurt. Noticed it about some days back and although it seems to have started small it is bigger today, she has been meaning to go to the hospital but she hasn't had much time yet.
She felt because it is not aching maybe it is not serious and it might go on its one eventually. Upon examination I realized that it was quite hard to touch, it wasn't tender in any way and she didn't complain of pain when I touched it too. At this point, I was concluding on Chalazion already because Stye which is very similar to Chalazion is a bit painful and it is mostly found at the lid margin.
Then again it could be other cysts whether malignant or benign or something else entirely, so I gave her some topical anesthetic and I everted her lid for a proper look, yeah, it looked like chalazion alright. Chalazion comes about when there is a non-infective inflammation of the Meibomian gland within the lid, the accumulation of the lipid produce as it is not able to flow onto the eye hardens and gives the swelling appearance.
It is not painful because it is non-infective although when it stands for long it can become infective and then it would start to ache. It normally gives a sense of heaviness on the eye and can come up more than once, I don't mean recurrent in this case although it can be recurring, I mean you could have multiple chalazia on the eye at a go.
So what did I do for her? Well since it is an inflammatory condition I gave her some non-steroidal orals, then I gave her some steroid-antibiotic combination eyedrops to facilitate the recovery process and then she was asked to do some mild compresses for the next 3 to 5 days to help ease the sebum accumulation through the necessary channels within the lids, then she should be fine if it is not compromised in any way.
Conclusion
It is been a while since I had visits to remote areas for free health care and so I was pretty much excited about this one even more exciting is the fact my hospital has decided we are going to make this routine, maybe I would be making video logs of these expeditions to share with you in the days ahead.
@nattybongoBut I do hope that you enjoyed the read and that you had fun and learned a thing or two. Before I go let me quickly remind you not to purchase over counter drugs for eye use without proper consultation and diagnosis from a certified eye care provider, when in doubt speak to a professional and please note that my articles are to enlighten us all and not to serve as a diagnosis reference. It is a pleasure serving you and thank you once again for your time.
Further Reading
Jordan, G. A., & Beier, K. (2022). Chalazion. In StatPearls. StatPearls Publishing..
Loth, C., Miller, C. V., Haritoglou, C., & Messmer, E. S. B. M. (2022). Hordeolum and Chalazion : (Differential‑)Diagnose und Therapie [Hordeolum and Chalazion: (Differential) diagnosis and treatment]. Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 119(1), 97–108. https://doi.org/10.1007/s00347-021-01436-y.
Evans, J., Vo, K. B. H., & Schmitt, M. (2022). Chalazion: racial risk factors for formation, recurrence, and surgical intervention. Canadian journal of ophthalmology. Journal canadien d'ophtalmologie, 57(4), 242–246. https://doi.org/10.1016/j.jcjo.2021.04.023.
Li, J., Li, D., Zhou, N., Qi, M., Luo, Y., & Wang, Y. (2020). Effects of chalazion and its treatments on the meibomian glands: a nonrandomized, prospective observation clinical study. BMC ophthalmology, 20(1), 278. https://doi.org/10.1186/s12886-020-01557-z.