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Sunday, July 27, 2008

Some aspects of Chalazion with homoeopathic mode of treatment

A chalazion is a chronic granuloma of one or more than one meibomian glands.

Pathology- A low grade infection, entering through a duct of the meibomian gland, causes infiltration of the wall of the duct with leucocytes along with proliferation of the epithelium of the duct. The duct, thus, becomes obstructed and the meibomian secretion accumulates within the gland. The retained secretion causes irritation resulting in infiltration of the surrounding tissues with inflammatory cells and consequently formation of a granuloma. Much of the glandular tissue is thus ultimately replaced by granulation tissue which undergoes hyaline degeneration forming a jelly-like mass.

Histology- A chalazion consists of sebaceous material in the centre surrounded by giant cells, epitheloid cells and lymphocytes.

Associated Conditions- It may be associated with blepharitis, rosacea or seborrhoeic dermatitis. Chronic chalazion may be associated with hypercholesterolemia.

Age- A chalazion is more common in adults than in children.

Presentation- Presentation is usually at any age with a gradually enlarging painless nodule (swelling).

Symptoms- Depending on the size of the chalazion, there may be a sense of heaviness in the lid and mild irritation. Occasionally an upper lid chalazion may press on the cornea inducing astigmatism and consequently blurred vision.

(1) A single or multiple roundish, firm swellings of variable size within the substance of the lid in the tarsal plate, a little distance away from the lid margin.
(2) It is painless or there is initial tenderness followed by little or no tenderness.
(3) The swelling is fixed to the tarsus, with the skin freely moving over it.
(4) On everting the lid, the conjunctiva over it is found to be engorged and velvety in colour.
(5) The regional lymph glands are not palpable.

(1) A very small chalazion may undergo resolution.
(2) A chalazion may remain as it is.
(3) A chalazion may gradually increase in size over weeks or months and then may remain stationary & may even slowly regress.
(4) A chalazion may burst either on the skin surface or on the conjunctival surface, with granulation tissue protruding.
(5) A chalazion may be secondarily infected leading to the formation of an internal hordeolum.
(6) A chalazion may affect a meibomian duct or may protrude through a meibomian duct when the nodule is found to develop at the lid margin and is called a marginal chalazion.
(7) There may be calcification of a chalazion.
(8) A chalazion may recur.

(1) Lid hygiene should be promoted.
(2) Diabetes mellitus should be excluded by necessary laboratory investigations.
(3) Hypercholesterolemia should be excluded by necessary laboratory investigations
(4) Refractive errors, if any, should be corrected with proper glasses (spectacles) or contact lenses.
(5) Recurrent chalazia, especially in old people should arouse the suspicion of malignancy.
(6) Hot compresses may be applied, especially if there is pain or tenderness.
(7) Of the homeoepathic medicines, Conium 200 twice in the morning at an interval of three hours and Staph (Staphysagria) 200 twice in the evening also at an interval of three hours should be used for at least one month. If not recovered, the same dose schedule should be continued for another month and then stopped. Kali Iod 200 may also be tried.
Labels-Astigmatism, Blepharitis, Chalazion, Conium, Cornea, Homeoepathic medicine, Resolution, Kali Iod, Gland, Granuloma, Hypercholesterolemia, Internal Hordeolum, Lymph gland, Malignancy, Meibomian, Staph (Staphysagria), Treatment, Vision, Hygiene, Refractive errors, Glass, Spectacles, Contact lenses, Diabetes mellitus, Rosacea, Seborrhoeic dermatitis, Hyaline degeneration, Sebaceous, Giant cell, Epitheloid cell, Lymphocyte.

IN SHORT- Chalazion is manifested as a painless single or multiple firm swellings of variable size within the substance of the eyelid, a little distance away from the lid margin. Treatment is followed as mentioned above.
But in every case a doctor should be consulted.

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