What is that Lump on Your Eyelid? | James Croley III, M.D. (2025)

Welcome to Case of the Day!

Today, a young man came in complaining that he had a bump or lump on his upper lid, which had been there for approximately a month. It wasn’t changing in size; he wasn’t that concerned about it, and it was only minimally tender to touch. When we examined him, he had what we call a chalazion.

A chalazion is a cyst that forms in the meibomian glands in your eyelids. You have a set of glands on the upper and lower lids that secrete the lipid layer or the outer oily layer of your tear film, and sometimes, they get plugged up and form a cyst. These cysts are usually not infected, but they can be in some cases, and people can have an infection inside the gland.

Something similar but not exactly the same is called a stye or hordeolum. It is a little different because it is an infection in a sebaceous gland in your lid. A chalazion may not be an infection; it’s just a cyst. They’re treated similarly and look very similar, so it’s really a matter of medical terminology because you do the same thing for both.

There are occasions where people get chalazion that gets bigger and bigger and becomes painful, but many times it happens, and it forms sort of a little hard nodule in the lid, which may stay there for an extended period of time.

The treatment when someone initially comes in is telling them they can try hot compresses. We tell people to take a washcloth, put it in hot water (as hot as they can stand it without burning themselves), and apply the compress to their eyes. When it cools off, put it back in the hot water and then put it back to your eye and keep your lid heated up for about 15 minutes. If you can do that four times a day, that’d be great.

Often, that alone will take care of the chalazion, and it will resolve and go away especially if someone starts doing that early in the process. If it does not go away and forms this nodule, it can be something the patient doesn’t want or is painful. A chalazion can occasionally cause blurred vision. A bump on the upper lid rubbing across the cornea when you blink can distort your cornea and blur your vision, so sometimes it is removed. If it’s not going to go away, we go ahead and operate and clean or remove the cyst.

How is this operation done? We take an injection of local anesthetic and put it into the eyelid (that’s the bad part of the procedure), and then we have a little clamp that we put on the lid to flip the lid inside out. Then, we make the incision on the inside of the eyelid, not on the outside. We open the cyst and then clean out the mucus, which could be pus-like material, out of the cyst. We have a little curette that has fine little teeth, and we clean out that cyst area because if we don’t do that, the cystic wall that remains could form a cyst again. We have to scrape and clean it out and get it clean. Finally, we typically put people on an antibiotic eye drop for a week to 10 days and have them continue hot compresses after the procedure. Better than 90% of the time, that procedure will get rid of the chalazion.

Chalazions are very common. People tend to get them. A lot of children get them, young people get them, and then through middle age, we don’t see them quite as much. As people get older, they return sometimes, and people get them again. It’s sometimes associated with a disease called blepharitis, an infection or inflammation around the eyelashes, and that’s exactly where those little meibomian glands open. Someone with chronic blepharitis typically has a lot more chalazion developed. If you have blepharitis, it’s essential to keep your lids clean to keep blepharitis under control.

If you have any questions about a lump on somebody’s lid or a chalazion, you can always contact us through our website. Dr. Croley will be happy to answer any questions. If not, may God bless you with healthy eyes and great vision.

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At the Cataract & Refractive Institute of Florida, our board-certified ophthalmologist, Dr. James E. Croley III, uses state-of-the-art tools and techniques to help his patients manage their eye conditions. Dr. Croley is a member of the following professional organizations:

CAPE CORAL

LEHIGH ACRES

BONITA SPRINGS