A chalazion is a common, usually painless lump on the eyelid. It forms when a meibomian oil gland becomes blocked, causing a build-up of oily secretions and a resulting inflammatory reaction. While many chalazia resolve on their own with warm compresses, persistent lesions often require medical intervention. For stubborn cases, an intralesional corticosteroid injection offers a quick, non-surgical treatment option.
How Corticosteroid Injections Treat Chalazia
Chalazia form due to sterile inflammation, making antibiotics generally ineffective. Corticosteroid injections, often using triamcinolone acetonide, target this underlying inflammatory response. The steroid is a potent anti-inflammatory agent designed to shrink the granulomatous tissue that forms the lump.
When injected directly into the chalazion, the medication works locally to suppress inflammatory cells. This action reduces swelling and breaks down the lesion’s contents, allowing the blocked material to be absorbed by the body. The procedure is fast, using a fine needle to deposit the concentrated steroid suspension directly into the core.
Resolution Timeline and Influencing Factors
Full resolution after a steroid injection is not immediate and depends on several factors. Patients often notice initial softening or slight size reduction within the first few days to one week. Complete resolution is a gradual process that generally takes between two and four weeks, though final flattening may take up to six weeks. The steroid is often a crystalline suspension, which allows for sustained release of the medication over this extended period.
The size of the chalazion is a primary factor, as smaller lesions resolve more quickly and completely than larger ones. Chronic lesions present for many months may have thicker tissue and respond more slowly to the injection. The specific technique, including precise placement and concentration of the steroid, also plays a role. Continuing warm compresses and gentle lid massage after the injection can help facilitate material breakdown.
When Further Treatment is Needed
Corticosteroid injections are highly successful, with reported success rates ranging from 70% to over 90% after one or two treatments. However, some chalazia may fail to resolve completely after the initial injection. A common protocol is to wait four to six weeks following the first injection to allow the steroid its full effect before assessing the outcome. If the lesion persists, a second injection is often recommended and is effective in achieving resolution. If the chalazion still remains after two injections, or if it is very large, the ophthalmologist may suggest Incision and Drainage (I&D), a minor surgical procedure to physically remove the contents.