webeye.ophth.uiowa.edu
webeye.ophth.uiowa.edu
webeye.ophth.uiowa.edu

Chalazion is a lipogranulomatous inflammation of the meibomian gland. Due to the infiltration of giant cells in this chronic inflammatory granuloma, it is suspected that chalazia may be caused by a host response to foreign material derived from several pathogens, including mites. Demodex folliculorum and Demodex brevis are the most common mites that stay on the surface of our bodies. Prevalence in younger patients, less than 20 years of age is about 13 to 20% and this increases with age and approaches to 95 to 100% by age of 70 years.1-3 A few reports have described the presence of mites in tissue sections of a surgical specimen4 and in lashes of an adult patient with chalazia.5 Recently, Yam and co-workers conducted a retrospective study that reported a high incidence (72.9%) of Demodex infestation in 30 adult patients with recurrent chalazia.6

This week’s abstract focuses on a prospective, observational, comparative study that looked at patients with chalazia (44 adult and 47 pediatric patients) and compared them with age and gender matched patients (34 adult and 30 pediatric) without chalazia.7 This study was conducted at the Zhongshan Ophthalmic Center (Guangzhou, China). Eyelash samples were collected and examined under a microscope for the identification and counting of Demodex mites. All patients (n=91) with chalazia underwent surgical removal of the lipogranulomatous lump and 74 of them were followed up for approximately 18 months after surgery. This study showed Demodex infestation was significantly more prevalent in patients with chalazia than in control patients as a group (69.2% vs 20.3%) and also when grouped into pediatric (70.2% vs 13.3%) and adult (68.2% vs 26.5%) subgroups (p < .001). Demodicosis was associated strongly with chalazia. Demodex brevis was significantly more prevalent than Demodex folliculorum in patients with chalazia. Patients with Demodex infestation tended to show recurrence, mainly in those with Demodex brevis.

This study suggests that ocular demodicosis is a risk factor for chalazia. Although crusts and debris on eyelashes is often a sign of Demodex infestation, eye doctors must pay careful attention for Demodex infestation while examining lumps and bumps on lids as well.

Treatment for Chalazion is hot compress – 4-5 times/day.  10-20 minutes each time.

Reprinted with permission from The Theralife Blog