Eye cyst

What is Eye Cyst?

“Chalazion,” commonly known as eye cyst,  is a Greek word meaning small lump [1]. This refers to as a small mass located either on the upper or lower eyelids wherein the root cause is inflammation of the area. Its consistency varies from firm, soft, or fluid-filled [2]. It is also known as tarsal cyst, meibomian cyst, or conjuctival granuloma [3].

 

Picture 1: Eye Cyst (Chalazion)

Source: aurorahealth.org

 

What are Eye Glands?

The eyelid glands are also referred to as tarsoconjunctival glands, meibomian glands, tarsal glands, or palpebral glands. [3]

There are about 30-40 eyelids for both upper and lower eyelids. These glands are responsible for the lubrication of the eyes at all times. They have tiny openings which function for the secretion of thick liquid secretions into the tear film of the eyes. The secretions are made up of sebum, which is a mixture of oil and mucus. [2]

 

Picture 2: The Eye Glands

Source: eyeconditions.cataract-surgery.info

 

Eye Cyst Causes

1. Bacterial Infection

This is the leading cause of eyelid cysts. Eye cysts are usually caused by the bacterium called Stapphylococcus.  [5]

2.  Eye duct blockage

When the oil produced by the eyelid glands becomes thicker than normal, the duct where the oil comes from becomes blocked. The production of oil is still continuous, but it can no longer reach the tear film where it is supposed to go. This leads to swelling of the glands that also results to dry eye. When the blockage becomes severe, this causes greatly enlarged glands or eye cysts. [3]

3. Improper hygiene

Microoganisms can be introduced to the eyes when you touch or rub them with your unwashed hands.

4. Cosmetics

• Use of expired cosmetics
• Leaving make up overnight

5. Eye contacts

Improper and unhygienic use of contact lenses exposes your eyes to bacteria and inflammation which may further lead to eye cyst.

6. Chronic blepharitis

This term is used to refer to a group of conditions involving inflammation of the eyelid margin.  It may be acute or chronic. Also, it can occur in patients of all ages. [7]

7. Skin Condition

Eczema in the eyelid is a chronic condition. This is characterized by itchy, reddish, scaly eyelids. [8]

Eye Cyst Symptoms

• The most common symptom of eye cyst is a lump forming on the eyelid.
• There is mild pain or irritation, especially when it just started.
• When the eye cyst becomes infected, there may be an occurrence of more pain and swelling.
• Sight us unaffected. It only affects vision when it becomes so enlarged that it presses on the eyeballs and distorts vision. [9]

Eye Cyst Diagnosis

In order to determine if the eye cyst is associated with any other condition and what management is needed, the eyelids are examined:

1. Macroscopically. This also refers to examining the eyelids using the naked eye.

2. With magnification. In this examination, slit lamp is utilized to better examine the eyes.

3. Biopsy. If the cyst is suspected to have malignant cause, biopsy is usually recommended.

The skin side and underside of the eyelids are assessed by the oculoplastic surgeon. During the entire examination, the patient is asked to keep the eyes open and looking down. The underside of the eyelids is everted to see if it has grey appearance. This finding would confirm the diagnosis. [10]

Eye Cyst Treatment

1. No treatment

• One third of the eye cysts can disappear without using any treatment.
• This is usually the first thing that doctors advise. This may take time, between 2 to 6 months or more to disappear. If the eye cyst does not cause any sight or other problems, it’s best to wait for it to resolve. [9, 11]

2. Warm compress

• This simple remedy is the most effective treatment of eye cyst.
• Applying warm compress relieves discomfort. Warmth and slight pressure that comes from the compress soften the cyst. Thus, it drains it more easily.
• Be sure to check the temperature of the warm compress. It must feel comfortable, not scalding. [9, 11]

3. Massage

• Massage the area of the eyelid where the cyst is using the warm compress. This is done to enhance the draining of the cyst.
• Remember to wash hands before massaging the area. Cotton buds may also be used.
• In massaging the cyst, move towards the direction of the eyelashes. [9]

4. Cleaning the eyelid

• Cleaning the eyelid is advised twice a day. This removes the grease and grime which is associated with the formation of cyst.
• Using a weak solution such as baby shampoo mixed with warm water is ideal. [9]

5. Medicines

• Antibiotic ointments: This is prescribed when the eyelid cyst is infected.
• Steroid injections: A steroid (cortisone) injection is administered to decrease the inflammation caused by the eye cyst.  [1]

6. Surgical Removal: Incision Curretage

• If the eye cyst remains after the medical treatment, the doctors proceed with surgical options. A local anesthetic is administered to the patient. An opening to the cyst is made to drain its contents. Then, a small resection of the cyst wall is made.

 

Picture 3: Injection of local anesthetic to the eyelid

Source: clinicalondon.co.uk

• After putting a local anesthesia on the eyelid, a small clamp is used to evert the eyelid. A pressure may be felt, but there is no pain. Then, the eye cyst is incised from the underside of the eyelid.

 

Picture 4: Everting the eyelid using a clamp

Source: clinicalondon.co.uk

• Drainage of the old inflammatory debris is performed. Then, the cavity is curetted. The result of this is an empty and clean eye gland duct.

 

Picture 5:  Drainage and Curettage of the eye cyst

Source: clinicalondon.co.uk

• After the procedure, the eyelid is padded with antibiotic ointment for 24 hours. Then, an antibiotic ointment will be applied on the eyelid from 5 to 10 post surgery. [10]

 

Picture 6: End of the Incision Curettage

Source: clinicalondon.co.uk

 

Eye Cyst Complications

• Most of the time, cysts rarely cause problems. But if the cyst becomes infected, this may spread to other parts of the eyelid and tissues surrounding the eyes. When the eyelid becomes swollen and red, opening the eyes may be difficult. This may also cause pain and fever.
• Orbital cellulitis: There are instances that the eyeball is pushed forward. This results to sticking out of the eye, making it photosensitive.If complication a like this developed, seek medical professional immediately. It can be treated with antibiotics, via intravenous drip, at the hospital. [9]

Eye Cyst Prognosis

An eye cyst usually does not affect the sight. It rarely occurs when the lump becomes large to distort vision. Also, the pressure caused by the cyst does not cause glaucoma. Not only that, it is not malignant contagious[3]. Some people are prone to developing eye cyst even if they already had it before [9].

Eye Cyst Prevention

• Make sure that makeup used is not out of date.
• Refrain fromdrawing eyeliner near the outer edge area.
• Do not share makeup or cosmetics with others.
• Always use clean contact lenses.
• Do not rub or touch eyes with unclean hands.
• For people with recurring eye cyst, apply warm compress to the eyelid before bedtime. This is to prevent clogging of the eye gland ducts at night.
• Maintain optimal hygiene in eye care. Gently wash it on regular basis (morning and evening). [3, 11, 12]

Points to Consider

Eye cysts are totally preventable. Maintain highest quality of hygiene when it comes to eye care. It does not only prevent the occurrence of eye cysts but also protects it from getting an infection. Care with cosmetics and contact lenses is also necessary to avoid from suffering the disturbance of having an eye cyst.

 

References:

1. http://www.eyehealthcenterofflorida.com/eye-conditions/chalazion/

2. http://lasikdoctor.acozo.com/eye-cyst-causes-symptoms-and-treatment/

3. http://www.medicinenet.com/chalazion/article.htm

4. http://eyeconditions.cataract-surgery.info/meibomianitis.html

5. http://cysteye.treatment.li/eyelid_cyst_treatment.html#.UZ26uNJkR9A

6. http://www.eyehealthweb.com/eyelid-cyst/

7. http://www.patient.co.uk/doctor/blepharitis

8. http://www.rightdiagnosis.com/e/eyelid_eczema/

9. http://www.patient.co.uk/health/Chalazion.htm

10. http://www.clinicalondon.co.uk/chalazion-meibomian-cyst/

11. http://www.irishhealth.com/article.html?id=249

12. http://www.medicinenet.com/chalazion/page2.htm