Chalazian

[eric1548]

On Monday I noticed some irritation on one eyelid.  Tuesday it was swollen.  By Wednesday it was worse so I went to opthamologist who disgnosed Chalazion and prescribed warm/hot compresses several tmes a day and TOBRADEX eye drops 4 x a day + TOBRADEX ointment at night.  It is now Saturday, six days later, with eye worse.

Does this seem like good advice?  Is it usual that a Chalazion will get worse after initial appearance and after treatment has started  I am away from home for work which makes me less secure about medical care.  At what point does surgery become necessary?  How long should I go on with this treatment?  

I see the doctor ten days after I last saw her that's five days from now.  Thanks.

[Houman Vosoghi, MD]

It could take up to four weeks for it to resolve and the treatment you were prescribed is typical.  It it is not gone by 4 weeks, incisional drainage may be necessary.

HV

[eric1548]

Dr Vosoghi
Thanks for your advice.  You've been very helpful!
Today I called the doctor here  She said that the whitish pimple on the Chalazion could be s sign that it might drain.  Said to put TOBRADEX onitment on it.  I see her on Thursday.  
Thanks again.  

[Houman Vosoghi, MD]

Treatment is adequate.  I would add that as long as you are on tobradex ointment (which has steroids in it) you need an eye exam with a pressure check every 3 weeks or so to make sure you are not developing glaucoma (I personally never leave a patient on it longer than 3 weeks).  If it is comming to a head, it is a good sign that it might drain on its own.  Keep doing warm compresses three or more times a day as that is the most effective treatment for making it drain out so surgery will not be necessary.  Don't worry about having to wait a couple of months to get back to US for surgery as it is not urgent to do.

HV

[eric1548]

Dr Vosoghi,  I appreciate your comments.  Work has me overseas in a country that does not have the best medical care. This is causing me double anxiety.  I believe that the two doctors I have seen are knowledgeable but if surgery becomes necessary I am not convinced that I want it here.  Let me bring you up to date.  It is now two weeks since this problem began.  The Chalazion remains approximately the size of a pea however in the last day or so it seems to have grown a sort of slight blister - similar in color and appearance to acne.  I feel that my vision in the affected eye is somewhat blurry.  I see the doctor again in a few days and will call attention to this.  Since I last wrote I consulted a second doctor who made the same diagnosis. Both doctors prescribed an antibiotic - Augmentin 1 g to be taken twice a day for three days.  Both doctors have expressed the opinion that surgery is most likely going to be necessary.  The second doctor said that he could not do any surgery now as he has to be sure there is no infection.  He explained that surgery at this point could cause it to spread.  The second doctor slightly changed treatment.  Rather than take TOBRADEX eye drops 4 x a day I should use them 3 x a day and use TOBRADEX ointment twice a day.  The second doctor feels that the ointment is more effective.   He assured me that these medications will not have any adverse effects (other than a few minutes of blurriness after application of the ointment) if used for a few weeks.  I have tried to contact my eye specialist in the US however even though I have a Skype number with a local US area code he has not called me back.  I am quite anxious about this, in large part because I am overseas, and also because of what I believe is some blurriness in the affected eye.  Is the treatment prescribed appropriate and conservative?  Can I wait two months to consult my doctor in the US and have surgery if this problem has not resolved itself?  I'll be back in the US for five days at that time.  Leaving before then could compromise my job and I am only working abroad due to the terrible economy in the US and age discrimination.  Your input is much appreciated.  

[Houman Vosoghi, MD]

Chalazion surgery is never an emergency and can wait till you are ready for it.  Hopefully that will not be necessary.  You have plenty of time left for it to go away with conservative management.

HV

[nugget212]

Hi Eric,my opthalmologist suggested that for hot compress, to place some uncooked white rice in a clean white stocking, and tie the top in knot. Place  in microwave for 10-15 seconds, and only warm it to where it feels comfortable when placing on top of your hand, as that area is tender like your eye lid.   Place rice bag on eye. it retains enought heat to turn it over once too. What i do know is not to put press on those styes, just let warmth soften then up.  Wash that area too, before the warm rice pack, and after, and your hands too :)     At least 4-5 times a day.  good luck..styes are no fun, but your continuing to warm it will do wonders.  

[eric1548]

It is now one week and it is much worse, somewhat affecting vision.  If it does not clear up within three weeks, can I wait until I am back home in January for surgery or would it have to be done earlier?  Is there any risk to vision caused by Chalazian?  Thanks.