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Chalazion in a child. Removal of a chalazion surgically Technique for performing an operation for a chalazion

Chalazion - a tumor-like formation on the upper or lower eyelid, is a consequence of blockage of the meimobian glands. It rarely goes away on its own, so it needs treatment. In the initial stages, conservative therapy is effective. In advanced cases, an alternative to medicines is to remove the chalazion with a scalpel or laser.

Surgical removal of a chalazion is one of the last resorts. They rarely resort to it, only if necessary. Usually, a tumor on the eye responds well to therapy with eye drops and ointments. With an impressive size, injection of corticosteroids into the tumor is indicated.

In cases where the above therapy does not bring the desired result, the ophthalmologist may decide on the surgical treatment of the chalazion.

The main indications for radical therapy are:

lack of results from drug treatment;
the size of the cone has reached 5 mm or more;
multiple chalazion, when not one gland, but several, is involved in the pathological process;
recurrent form of the disease;
formation of a cyst, abscess on the eyelid;
the development of complications, such as loss of vision, pterygium, etc .;
there is a suspicion of the degeneration of the chalazion into a malignant tumor.

Preoperative diagnostics

Before resorting to excision of the chalazion, the patient undergoes an examination. It helps to assess his general condition and identify possible contraindications. What tests are done before the operation? These include:

study of blood coagulability indicators;
general blood and urine tests;
determination of blood sugar levels;
testing for hepatitis B.

Preoperative diagnostics also allows you to determine the tactics of proper patient care during the rehabilitation period. For example, with immunodeficiency after surgery, the risk of infection is high. Therefore, in the recovery period, the patient is prescribed a course of antibiotics.

Contraindications

It is impossible to remove a chalazion on the eye if:

acute conditions: heart attack, stroke;
acute inflammatory process: before treatment, it is necessary to perform an operation to remove suppuration. The chalazion is removed directly after the inflammation subsides;
infectious and viral diseases: SARS, influenza;
pregnancy and breastfeeding: local anesthesia can adversely affect the condition of the mother and child.

Operation technique

Modern medicine has in its arsenal several ways to remove a chalazion: traditional surgery and with a laser. The choice of tactics is determined by the attending physician, depending on the type of disease and the patient's condition.

Laser treatment is considered safer, however, compared to conventional surgery, it is more expensive and is carried out mainly in private medical clinics.

In some medical centers, the chalazion is removed by the radio wave method - using a special Surgitron apparatus.

Surgical removal

The traditional operation to remove a chalazion is performed on an outpatient basis. Therapy in the hospital is meant only in advanced cases and suspicion of malignancy of the formation. The intervention is not severe, well tolerated by the patient and does not last more than half an hour.

How to remove a chalazion surgically:

An anesthetic is injected into the eyelid area to make the process painless.
The surgical field is treated with an antiseptic.
A luer clamp is applied to the eye. This allows you to fix the capsule and reduce the likelihood of bleeding. If the nodule is accessed through the conjunctiva, the eyelid is turned outward.
An incision is made and the liquid is removed with a special curette. The capsule itself is also removed with a scalpel and surgical scissors.
After removing the capsule, apply Tetracycline ointment behind the eyelid and apply a bandage. It helps prevent bleeding from damaged vessels. If the eyelid is incised from the outside, apply a few stitches to the wound. Subsequently, the sutures are removed on the fifth day. Or, if self-absorbable sutures are used, there is no need to remove the sutures.
The contents of the capsule must be sent for histological examination to determine the nature of the tumor (benign or malignant).
The next day after the removal of the chalazion, the bandage is removed from the eye and washed with an antiseptic.
If access to the capsule was carried out through the conjunctiva, the patient is prescribed to wear soft contact lenses for 4-5 days. They protect the postoperative scar from contact with the cornea and relieve discomfort.
Three days after the operation, the patient returns to normal life.
Within 10 days, the patient is prescribed eye drops and antibacterial ointments. It is forbidden to scratch, rub, rinse the eye with water so that there are no complications.
On the tenth day, a control examination by an ophthalmologist is carried out.

Treatment with a laser

Removal of a chalazion of the lower eyelid or upper eyelid by the laser method takes place in approximately the same order as an ordinary operation. Anesthetic drops are applied to the conjunctiva area and an anesthetic is injected. Then the affected eyelid is fixed. The tissue is cut with a laser and the chalazion is removed. The contents are sent for histology.

The differences of the method are:

tissue incision and the operation itself are carried out using a laser. They also treat the wound after the operation;
Since the laser simultaneously cauterizes the incised tissue, the chance of bleeding is minimized. Therefore, a tight bandage is not applied to the eye. Seams are also not applied;
The patient is sent home immediately. And the very next day the patient can return to normal life;
after surgery to remove the chalazion with a laser, the disease no longer recurs. The patient comes to the ophthalmologist in two days.

Surgical treatment of chalazion in a child

Chalazion of the upper and lower eyelids in a child is quite common. The most common cause of a nodule is the habit of rubbing your eyes. Through dirty hands, the infection enters the eye. The development of the disease due to a cold and a decrease in immunity is not excluded. If there is a malfunction of the sebaceous glands, inflammation of the eyes occurs.

Preference is given to conservative therapy, but in some cases surgery is indicated. They try to remove the chalazion in children using the laser method, since recovery in this case is much faster.

Unlike adults, children are almost always operated on under general anesthesia to avoid the psychological consequences of the operation. The child may be left in the hospital for a few days after the operation to monitor his condition.

The operation itself is performed for children in the same way as for adults. Since the disease is more prone to recurrence in childhood, special attention in the postoperative period is paid to preventive measures:

use of personal towels;
keeping hands clean;
exclusion of contact of hands with eyes;
an appeal to an ophthalmologist at the first signs of eye diseases;
boosting immunity.

Recovery period

During recovery, the patient should clearly follow all the doctor's instructions. Do not apply dry heat to the eye area, even if you are sure that there is no pus there. It is not recommended to massage the eyelid yourself until it has healed.

How long does it take for an eye to heal after a chalazion is removed? Depending on the type of intervention, this period ranges from two to ten days. It is necessary to agree in advance with the doctor and take a sick leave from him if the profession involves eye strain during work.

Possible Complications

In the postoperative period, undesirable consequences are not excluded:

edema. Usually swelling disappears within 2-3 days;
bruise. It resolves on its own in a few days;
corneal deformity. This complication is more common after laser surgery;
scar, scar on the eyelid, causing discomfort when blinking;
recurrence of the disease in the same place. It is possible if the capsule was not removed or was not completely removed;
wound infection. In this case, an inflammatory process develops, the wound begins to fester, which requires treatment.

To avoid complications, follow these rules:

avoid eye contact with water for 1-1.5 weeks. This will prevent infection from getting into the wound;
do not touch or scratch the postoperative area;
it is forbidden to tear off the crusts on the wound on your own. They must fall away on their own;
do not visit the pool and open water until the eye is completely healed;
within three days after treatment, avoid walking on the street. Dust can get into the eye and cause inflammation. If you need to go outside, wear sunglasses.

Removal of a chalazion by surgery is a simple and non-traumatic treatment. If the doctor advises resorting to it, you should listen to him and follow all the recommendations. Then the recovery will be quick and without complications.

Removal of a chalazion is resorted to with the failure of drug therapy. The disease occurs when the meibomian glands become blocked. Their function is the production of a water-fatty film that protects the eye from drying out. Need to start treatment as soon as possible medicines to avoid surgical removal.

There are several operations to remove a chalazion: surgery, laser and electrocoagulation. Which will be better for a particular person, the doctor decides on an individual basis. Laser removal is considered the most modern and safest method.

Indications for removal of education:

Large size (more than 0.5 cm).
Several chalazions.
Lack of effect from drug therapy.
Complications (abscesses, cysts, pterygium).
Frequent relapses after treatment.
Suspicion of oncology.
Visual disturbances, discomfort.
Correction of a cosmetic defect at the request of a person.

Surgical removal is contraindicated in:

inflammatory diseases of the visual organ;
common inflammatory diseases (ARVI, chronic diseases during an exacerbation);
blood clotting disorders;
alcohol intoxication;
mental illness that prevents contact with a person.

Is surgical treatment always required, watch the video:

Removing education

The operation to remove the chalazion is done in public or private clinics. Removal is carried out quickly (15-30 minutes), on an outpatient basis, the risks of complications are minimal.

No special preparation is required. Previously, a person must pass the KLA, OAM, blood for clotting and infectious diseases(HIV, syphilis, hepatitis B, C).

Removal with a scalpel

The person is taken to the operating room, laid down. With the help of sterile tissue, the operating field is limited, leaving only the operated eye accessible. The surgical field is treated in compliance with the rules of asepsis and antisepsis. The course of the procedure:

Local anesthesia. Painkillers (lidocaine, dicaine, novocaine) are injected with an insulin syringe with a thin needle. Beforehand, the doctor specifies the presence or absence of an allergy to anesthetics.
Fixation. Applying a clamp to fix the chalazion capsule, as well as to prevent bleeding. If the chalazion is removed from the inside of the upper or lower eyelid, the doctor turns the eyelid inside out.
Formation of access. An incision is made with a scalpel. On the inside - in a perpendicular direction to the edge of the eyelid, on the outside - parallel to the edge of the eyelid.
Removal. Using a Meyerhoffer chalazion curette, the contents are removed. The capsule is carefully excised. If it is left, then the risk of re-formation of the chalazion increases.
Sewing up the incision. Only incisions on the outer side of the eyelid are sutured. Usually make cosmetic seams. If absorbable suture material is used, the threads will fall off on their own after a few days. If the material is not absorbable, then the sutures are removed on the 5-7th day with successful healing.
Prevention of infectious complications. An antibacterial ointment is applied over the eyelid, a sterile pressure bandage is applied.

After removal, the resulting material is sent for histological examination. This is necessary to determine the cellular composition and exclude oncopathology.

An alternative to surgical removal is laser treatment. The positive aspects of laser removal of a chalazion are associated with an ultrathin laser beam, which does little damage to the tissues of the visual organ. This allows you to refuse suturing, promotes rapid recovery.

After laser treatment of a chalazion, a pressure bandage is not required. The risk of complications is lower than after surgical treatment.

Electrocoagulation

The method of electrosurgical removal is electrocoagulation. The essence of the technique is the removal of the chalazion capsule with the help of an electric knife. The electric knife acts with an electric current on the affected area, cauterizing it. After the operation, a crust forms, which leaves on its own after a few days.

After electrocoagulation, no stitches are needed, scars do not form. The recovery period is relatively short, not associated with a high risk of complications.

Removal in children

The operation in children is carried out as in adults. The only thing is that general anesthesia may be required if the child is active and cannot lie still. This is typical for the younger age group. For small children, try not to get stitches, because there is a high risk of damage due to chafing of the eyes.

Chalazion in children often recurs. Be sure to have a conversation about eye hygiene, maintain good immunity.

Consequences of the operation

In the first days after surgery, swelling of the eyelids, redness, lacrimation, and a desire to rub the eyes are noted. These symptoms are not dangerous and pass quickly.

If the chalazion capsule remains, then after the operation it can develop again. Occasionally, infectious complications occur: conjunctivitis, keratitis, purulent processes. This is due to the penetration of infectious agents during or after the operation (if preventive measures are not followed). Rough scars are extremely rare.

As a rule, the prognosis after removal of a chalazion is favorable; after surgery, complications and relapses are rare.

Recovery

During the recovery period, you can not wet and rub your eyes. Swimming in pools, natural reservoirs is prohibited. It is recommended to wear a soft lens that will protect the cornea from being touched by the suture material.

If you go out, wear large sunglasses. They protect the visual organ not only from ultraviolet rays, but also from dust.

How long a chalazion heals after surgery depends on the presence or absence of complications. With a favorable course of the postoperative period, recovery occurs after 5-7 days. In case of complications, this period is extended.

To prevent complications, the doctor prescribes antibacterial drugs: drops "Tobrex", "Floxal", "Tsipromed", ointments "Levomycetin", "Tetracycline". To relieve inflammatory manifestations, drops from the NSAID group are prescribed: Indocollir, Nevanak. Medicines should be used within 7-10 days, strictly observing the dosage. More about drops with chalazion -.

All materials on the site are prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative and are not applicable without consulting the attending physician.

Removal of a chalazion is a surgical method for treating an inflammatory process in the glands of the eyelids. The operation is performed on an outpatient basis, under local anesthesia, using a scalpel or laser radiation.

Chalazion is a fairly common pathology among people of all ages. Children, the elderly, people with pathologies of the immune system, the digestive system, and diabetes are especially susceptible to it. The disease, formerly called "hailstone" because of the peculiar appearance, develops as a result of meibomitis - inflammation of the glands of the eyelids, which produce a fatty secret that forms a protective film on the surface of the cornea.

When the lumen of the meibomian glands is blocked, which can also be facilitated by excessive oiliness of the skin, the excretion of a thick secret that accumulates inside is disrupted, causing the gland to expand, and the attachment of the infection leads to purulent fusion.

Chronic recurrent meibomitis is accompanied by the formation of a dense capsule around the focus of inflammation, which itself the chalazion takes the form of a pea with a diameter of up to 0.5-0.6 cm, which is visible to the naked eye and causes considerable cosmetic discomfort.

Chalazion does not hurt, does not lead to cancer, does not disturb the general well-being, however, in some cases, it is the external defect of the eyelid that makes patients go to ophthalmic surgeons. Chalazion becomes a particularly unpleasant problem for women who are accustomed to makeup and regular use of cosmetics, because it is not only difficult, but also harmful to “bring beauty” with such a disease, since cosmetics can aggravate the inflammatory process.

Before scheduling an operation, the doctor may advise a complex drug treatment that requires the patient to strictly and accurately adhere to the regimen, the dosage of eye instillation and meticulous hygiene. Some patients have to get up even at night to ensure a constant supply of antibacterial drug to the conjunctival sac, which is very uncomfortable.

An operation is required in advanced cases, when there is no hope for a cure in another way, or if the patient himself is professional activity or other personal reasons wants to undergo surgical treatment.

Indications, contraindications and preparation for removal of a chalazion

Surgical treatment of inflammatory processes of the eyelid is an extreme measure, which ophthalmic surgeons are forced to resort to in cases where:

Conservative treatment does not bring the desired result;
There are advanced forms of chalazion;
The dimensions of the purulent cavity are over 0.5 cm;
Pathology has a relapsing course;
Complications develop - abscesses, cystic cavities of the eyelids.

In some cases, the personal desire of the patient to undergo surgical treatment in order to reduce the total duration of the disease becomes an indication. People of public professions, celebrities in the field of show business, politicians are unlikely to want to undergo medical treatment for a long time, and there is no question of observing a clear multiplicity of eye drops and their antiseptic treatment due to the tight working regime.

For such patients, long-term drug treatment may seem unacceptable, which in some cases drags on for several weeks, so the solution is an operation that reduces the total time of the disease, even taking into account the postoperative recovery of the eyelid. And, of course, the method of choice in these cases is laser removal of the chalazion as less traumatic and with quick rehabilitation.

Since the operation to remove a chalazion does not require general anesthesia, the list contraindications quite small for her. It includes a general infectious pathology (ARVI, intestinal infections, etc.) until the moment of complete cure, the condition alcohol intoxication, some mental illnesses in which contact with the patient is disturbed or his behavior becomes inadequate.

Blood clotting disorders can also serve as a contraindication to the usual removal of a chalazion, but the issue of laser treatment is resolved with each patient individually.

The excision of the chalazion does not require any specific preparation. It is a minimally invasive treatment performed on an outpatient basis and is considered safe. Before surgery, the patient will be sent for a blood coagulation test, general analysis blood and urine, determination of markers of HIV, hepatitis, syphilis. This is a standard list of laboratory tests that are always required for surgical treatment.

At the appointed time, the patient comes to the ophthalmic surgery department and is immediately sent for surgery if there are no contraindications to it (for example, he caught a cold). In the operating room, he is placed on his back, his head and face are covered with a sterile napkin, leaving only the area of the operated eye open, the eyelids of which, together with the periorbital tissues, are treated with an antiseptic solution.

Operative removal of a chalazion

The operation to remove the chalazion is not very difficult. It takes only about 20 minutes, it can even be carried out on an outpatient basis, without subsequent hospitalization of the patient. Indications for surgical treatment are advanced forms of pathology, when drug treatment does not bring the desired result, as well as relapse of the disease.

Surgical treatment is possible by a conventional operation, when the formation is excised with a scalpel, as well as by a laser method - less traumatic and more modern. The choice depends on the technical capabilities of the clinic and the patient's ability to pay, since you will most likely have to pay for laser removal yourself.

In children, excision of the chalazion is performed more often under general anesthesia. For treatment, a scalpel is used, the incision is always made from the side of the conjunctiva and without subsequent suturing, so that the child does not damage the tied threads with a careless movement. Indications, contraindications and the operation technique itself are similar to those in adults, and postoperative prevention of complications with drops instilled into the eyes is the concern of parents who help the baby with healing.

Operation with a scalpel

Open surgery requires local anesthesia (novocaine, trimecaine, procaine). The anesthetic is injected into the area of the eyelid affected by the inflammatory process, gradually infiltrates the tissues and eliminates any sensitivity, making the intervention painless.

surgical removal of a chalazion

To fix the eyelid, a special fenestrated clamp is used with a hole into which the “hailstone” falls and which compresses the vessels, preventing bleeding. The chalazion can be excised from the side of the mucous membrane or through a skin incision. When dissecting the conjunctiva, the incision with a scalpel goes along the gland, that is, at a right angle to the edge of the eyelid, and if the access is from the outside, then the skin is cut parallel to it.

After the onset of anesthesia, fixation of the chalazion in the clamp, incision of the conjunctiva, the cavity of the gland filled with purulent-inflammatory exudate is opened. The contents of the cavity must be completely evacuated, after which the capsule of the gland is necessarily excised, the removal of which is important for the prevention of re-inflammation.

When the chalazion is completely removed, the eye is washed with sterile saline, and an antibiotic ointment (tetracycline, ofloxacin, erythromycin) is applied behind the eyelid. Sutures on the mucous membrane are not superimposed, as they can lead to injury to the cornea. The incision heals on its own. The skin wound is sutured with self-absorbable sutures; they do not need to be removed. The tissues excised during the operation are necessarily sent for histological examination.

To prevent bleeding in the postoperative period, a pressure bandage is placed on the eye, which can be removed the day after the intervention. When the bandage is removed, the eye is washed from the remnants of blood and for ten days the patient himself instills drops with antibacterial properties into the conjunctival sac or lays an ointment. After a few days, the doctor will allow you to return to your usual duties and lifestyle.

A negative, but inevitable consequence of the surgical treatment of a chalazion may be increased swelling, redness of the eyelid and the appearance of bruises, which gradually disappear during the first week after the operation.

Laser treatment of chalazion

The laser has been successfully used for recent years in almost all areas of medicine, but it is of particular importance where the surgeon is forced to manipulate in a limited area and where the cosmetic result is almost of paramount importance. The eye is just such an organ that requires very careful handling and minimal trauma.

chalazion laser treatment

Laser chalazion removal is a great alternative to conventional surgery, as the method has undeniable advantages:

Bloodlessness;
Lack of scarring after healing of tissue incisions;
Minimal risk of infectious complications;
Almost complete painlessness of manipulations.

The only disadvantage of laser treatment chalazion can be considered a relatively high cost of the operation itself and the need for expensive equipment that a qualified and experienced specialist can use. Today, laser equipment in ophthalmology is available in almost all major cities, so often the only question is the price of such treatment.

To remove the chalazion, a diode laser is used, the principle of which is based on heating tissues with evaporation of fluid from the cells, which leads to the elimination of the focus of inflammation along with purulent-necrotic masses. Vessels in action high temperature as if soldered, so bleeding is excluded, which is especially important for patients who have problems with blood clotting or are forced to constantly take blood-thinning drugs.

Another important effect of the laser in chalazion can be considered its bactericidal effect. In the lumen of the enlarged and inflamed gland, pus often accumulates, which is the result of the multiplication of pathogenic microbes, and the removal of the formation by a conventional operation can give a relapse due to incomplete elimination of the flora. The laser literally kills microbes, reducing the likelihood of recurrence of the pathology to a minimum.

The absence of sutures after removal of the chalazion with a laser allows the patient to return to their usual activities and work the very next day after treatment, while the recovery period will be very short and will not cause such discomfort as it happens after a conventional operation using suture material.

Laser treatment of a chalazion can be performed on an outpatient basis, and after the procedure, the patient may well leave the clinic. It is better not to plan driving trips, you can get home on your own by other transport, and if dizziness, fainting and other symptoms are likely after using local anesthesia or due to the patient's special sensitivity to any intervention, it would be right if relatives or close friends help to leave from the hospital.

The technique of the procedure is simple and includes several steps:

The introduction of a local anesthetic into the skin of the affected eyelid;
Fixation of the eyelid with a clamp;
An incision under the action of a laser beam in the area of the inflamed gland on the inside of the eyelid, passing along the duct, that is, perpendicular to the edge of the eyelid;
Removal of purulent exudate and formation capsule;
Instillation of drops or placing an antibacterial ointment behind the eyelid to prevent bacterial complications and relapse.

Postoperative period

During the first days after surgery, small crusts may form on the eyelid, which should not be removed by yourself. Experts also do not recommend rinsing the eyes with water, rubbing them if itching appears, applying decorative cosmetics and using other cosmetics until complete healing. The first visit to the ophthalmologist should be made no later than 2 days after treatment.

For some time, swelling and redness of the eyelid may persist, which pass on their own and do not require treatment. In addition, ophthalmologists additionally prescribe drops or ointment with an antibiotic for 7-10 days in order to prevent microbial infection - ointment floxal, tobrex or oftaquix in drops.

Non-steroidal anti-inflammatory drugs help to accelerate the disappearance of edema and redness, have an analgesic effect: nevanak, indocollir. To improve regeneration and reduce the inflammatory response, corticosteroid hormones can be used - maxitrol, dexamethasone, a combined preparation of tobrex containing both an antibiotic and a hormone.

If the patient experiences discomfort in the eye or needs to temporarily protect the cornea after laser chalazion removal, the doctor will recommend the temporary use of a special lens for up to a week.

In the postoperative period, in addition to antibacterial and anti-inflammatory therapy, immunomodulators and vitamins are prescribed. In some cases, a nutrition correction is required with a decrease in the proportion of fatty, smoked foods, an abundance of spices, pastries, and “fast” carbohydrates. In no case should the eyes be touched, rubbed, washed with plain water, or attempted to remove sutures in case of percutaneous access.

before/after treatment

The cost of surgical treatment of chalazion depends on the technique used and the pricing policy of a particular medical institution. The average price is 3-5 thousand rubles, although some clinics offer laser removal of chalazion for 10-12 thousand. The choice is up to the patient, who should know that the price is not yet an indicator of the high qualification of the surgeon, therefore, before treatment, it is imperative to find out how effectively patients are treated in a particular department or hospital. trust health better themes surgeons who have sufficient experience and a good reputation.

An operation to remove a chalazion is an extreme measure, which means that it is no longer possible to overcome the disease with other sparing methods, but it is quite possible to avoid it. To do this, it is important to consult a doctor in time, carefully follow all the recommendations regarding drug therapy, lifestyle, and nutrition. If the operation is inevitable, then it is better not to postpone it and get to the doctor as soon as possible.

Hello. Feedback on a medical procedure is always very personal and emotional. Unnecessarily, it is unlikely that many will stumble upon it. And since you have already entered, I wish you that this review will never be useful to you in your life. I usually start all my reviews with exactly the opposite words.

✍ Our history:

As you may have guessed from the title, I will talk about how the chalazion was removed for my son, and not for me.

Around May 2017, when my son was 4 years and 5 months old. we noticed a certain induration on his left eye. It was like a small dense lump under the upper eyelid. I thought it was some kind of internal pimple or wen, which will resolve over time. The summer season has begun, and I and my children went to the country for the whole summer. Behind the eye watched, but especially not worried. It's been about 2 months. Grandmothers were the first to worry. Dad took us to Moscow to see an ophthalmologist in the city's children's clinic. She said that we were too late with the start of treatment, that the chalazion, and she suggested that it was he, was already very dense and it was hardly possible to get rid of it with medication. But worth a try. We were just going to the sea for 2 weeks. The doctor assured me that this is very good for the treatment of chalazion. That in her practice there were cases when the chalazion burst from the hot southern sun and sea water.

✍ A little bit of theory:

What is this chalazion:

Halazion- chronic (unlike barley) proliferative inflammation of the edge of the eyelid around the meibomian gland and cartilage of the eyelid. The disease appears when the outlet channel of the gland is blocked and secretory fluid accumulates in it.

What it looks like:

On the eyelid, a dense formation the size of a small hailstone (pea) is palpable, the skin above it is raised, mobile, from the side of the conjunctiva there is an area of hyperemia (redness) and a grayish zone in the center. Palpation may not be very painful if there are no complications. Sometimes suppuration occurs, then signs of inflammation join: pain, redness of the skin of the eyelids, there may be a spontaneous opening with the release of contents (pus) from the conjunctiva.

Theory theory, but there are nuances. There was no redness on the eyelid of the child. The chalazion was high enough from the lash line. The child did not experience any discomfort from his presence. Pressing this seal was not painful.

✍ Medical treatment:

So, the doctor prescribed us conservative treatment for the next month:

Okomistin. 4 times a day, 1 drop.
Maxidex. 3 times a day, 1 drop.
Tobrex. 4 times a day, 1 drop.
Floxacin ointment. 1 time per night.

Because half of this period of treatment we were at sea, then we followed the recommendations of the doctor a little less strictly than required. I could not drip drops 3 times a day, as prescribed, but 2. As a result, the chalazion did not go anywhere. Where could he go? He could open up and leak out with pus. This is how the doctor explained it to me.

After a month of such unsuccessful treatment, we again came to an appointment with an ophthalmologist, determined to have an operation. The doctor confirmed the need for a surgical solution to the problem. I did not want to go to the doctors, take tests and wait in line for the removal of the chalazion. Therefore, we applied on a paid basis to the Morozov children's polyclinic with a referral from the ophthalmologist of the polyclinic to which the child is assigned at the place of residence:

It was September 8th. And already on September 14, we got a consultation with an ophthalmologist at the Morozov Children's Clinical Hospital.

The need for surgical removal of the chalazion was confirmed.

✍ How we prepared for hospitalization:

We already knew the rules of hospitalization in the Morozov Children's Clinical Hospital, because. a year before that, adenoids had already been removed to the son, and they are such that you need to send an electronic application:

I sent her to day, i.e. September 15th. I write all the dates in such detail so that those who care about the dates can easily navigate. After that, on September 19, my child and I arrived at the same Morozov Children's Clinical Hospital for paid tests. I also have a second child. At that time, he didn’t even go to kindergarten, so we tried to go through everything as less stressful as possible for all family members, i.e. for one visit to the hospital, but, of course, for money.

Early in the morning, my son and I came to the office assigned to us, signed an agreement to provide paid medical services:

and a friendly nurse took us through several rooms for tests. All this took no more than 2 hours. We had to pay almost 8,000 rubles for the tests.

Here is a list of those analyses. I don’t want to rewrite by hand, so I cut out only their names and price:

I photographed all the documents on the spot and sent them to my husband for insurance purposes. I don’t know what I was afraid of, but I was so calmer. Let him know what procedures are waiting for the child and how much he will have to pay for it. All the same, the amounts are not small in the end ran.

6 pdf files with information on analyzes were attached to the letter. I will not insert them here, because. they have little to do with the chalazion itself.

After that, I had to go again to the Morozov Children's Clinical Hospital to conclude an agreement for the operation itself and the hospital. My husband was already doing this, so no one took pictures of anything. The date of the operation could be chosen from several proposed ones. We did not want to delay this matter, so my husband signed us up for September 27th.

✍ Operation day:

For small children, the chalazion is removed under general anesthesia, while for adults - under local anesthesia. For my child, this was already the third anesthesia (). That's how sad it is. But every time its necessity was justified.

On an empty stomach, without a single sip of water in the morning, we arrived at the eye microsurgery building in the Morozov Children's Clinical Hospital. Because Our contract was concluded for the provision of services for a fee, so the husband paid for the stay in the ward of the mother and the child. The chamber cost 5800 per day. But there was no free paid chamber. We were placed in a common room. I was very upset, because in Russian hospitals, it is not assumed that parents accompanying children are people too. There is no food or bed for mothers. I perceive all sorts of everyday conditions of discomfort very painfully, so I tried to restore my rights to paid accommodation, where there should have been a bed, and food, and even a separate bathroom. node. But nothing came of it. Of course, I got my money back the next day. Resigned to my situation, I began to wait for us to be called. We had to wait several hours. At this time, both the surgeon (a woman) and the anesthetist came to see us. Everyone introduced themselves and briefly described the essence of the operation to me. Above the son's eye they put a tick with a blue pen right on his forehead. You see, so as not to confuse anything.

About one o'clock in the afternoon the anesthesiologist came for us and took me with the child to another floor. There was a gurney in the hallway in front of the operating room. On it, the son had to be undressed and covered with a sheet. He calmly treated all these manipulations. Only thanks to his calmness did I somehow hold on, although I was very nervous. Before the operating room, she could hardly hold back her tears, but she did, because. I was afraid to scare the child. They took him away. I returned to the room and waited. What I did at that moment, I do not remember. Opposite me was a mother with her son, who had already undergone surgical manipulations a few days ago. I probably talked to her so that time would pass faster.

After 40 minutes the cub was brought. He slept. I already knew how to behave with a child under anesthesia. She covered her head with pillows, sat down next to him, turned his head to the side and began to listen to his breathing. After 25-30 minutes, he began to slowly come to his senses. You can't drink for a few more hours. Nothing, we did it. By the way, I didn’t eat or drink with him either. For solidarity

This is what our eye looked like before surgery. After the operation, he was sealed with a pressure bandage for a day.

There were no negative effects of anesthesia. The child did not vomit. He quickly came to his senses and went to play. The next day the bandage was removed and we were allowed to go home.

Doctors have been trying to comprehend the secret of the occurrence of chalazion for more than a decade, but they have not come close to unraveling. They only in general terms understand the mechanism of its formation, but the causes of its occurrence are still trying to decipher.

In October 2017, in the upper eyelid of the right eye, a chalazion came off in my seven-year-old daughter. I was immediately very upset, because I myself had chalazions several times, and I know from my own experience that they are not amenable to conservative treatment. Only a hormonal injection into the chalazion cavity can save, but it is given only from the age of 16.

Terminology:

Ophthalmologists in the medical statement, as well as in the check, use the word "chalazion", but not "chalazion", apparently, this is a more competent medical term, but, in the old fashioned way, I will talk about chalazion, since this name is more familiar in the non-medical circle.

What is a chalazion?

Halazion is sometimes also called "cold barley", but this is fundamentally not true, because it has exactly the same relation to barley as a candle to the sun. I will not clutter up the review with medical terms and quotes, but I will explain the difference in a rather primitive, but most accessible way, that is, in my own words. A chalazion is when a bump forms in the eyelid (both in the upper and lower), without purulent contents, which does not particularly bother, does not hurt, but does not go away - the so-called "cold inflammation". This is a chronic focus, such as tonsillitis or caries. The chalazion seems to be harmless in appearance, but there is evidence that it can even degenerate into a cyst. Barley, on the contrary, is a real inflammation, pronounced, it is located outside and on the edge of the eyelid, where the eyelashes grow. Barley hurts, worries and passes quickly. In addition to a chalazion, my daughter had styes on her neighboring eye three times over the past six months.

To answer the main question of my review - is an operation necessary for chalazion, and to do this as concisely and intelligibly as possible, I should touch a little on how we tried to avoid the operation.

Conservative treatment:

Halazion stubbornly "sat" on my daughter's eyelid for exactly 7 months. At first, it was not very noticeable, and was only visible up close, when the daughter lowered her gaze down with the eyelid closed, but it was perfectly palpable during manual examination. During this period, we visited 4 ophthalmologists (paid and free), both of them just shrugged helplessly, appointing another useless conservative treatment.

Treatment regimen No. 1:

Treatment was started one day after the formation of the chalazion.

Drops Tobriss - 1 drop 3 times a day. The drops caused eyelid edema.

Treatment regimen No. 2:

Treatment was started a week after the formation of the chalazion.

Conclusion: Approaching the final conclusion, I will answer the main question that I indicated at the beginning of the review - Is it possible to do without surgery when the child has a chalazion? My answer will not be monosyllabic. If we are talking about a child under 16 years old, then the answer is unequivocal - NO, the operation, unfortunately, can NOT be avoided, and it will have to be done exclusively under general anesthesia. Although, fortunately, the operation to remove a chalazion is not as terrible as it seems, the recovery period is relatively short, there are no scars, there are no negative consequences for the eye, and vision does not fall from this. I do not want to exaggerate, but as my own experience and the experience of my child shows, conservative treatment is often just a waste of time. If we are talking about a child over 16 years old, as well as an adult, then there is no need for an operation, because the chalazion is perfectly absorbed under the influence of an injection of hormonal drug Diprospan. You can read about how I cured my chalazion and was able to avoid surgery in This review.