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  1. Esmaeil M Arbabi, senior house officer1,
  2. Ross J Kelly, general practitioner 2,
  3. Zia I Carrim, specialist registrar in ophthalmology,1
  1. 1Hull and East Yorkshire Eye Hospital, Hull HU3 2JZ
  2. 2Spencer Street Surgery, Carlisle
  1. Correspondence to: E Arbabi esarbabi{at}gmail.com
  • Accepted 7 June 2010

A 21 year old girl presents with a painless lump in her right upper lid. She says that this has been present for a few weeks and seems to be enlarging slowly. Her pharmacist suggested an antibiotic ointment, which she has been using for a few days with no benefit.

What you should cover

A chalazion, or meibomian cyst, is a focus of granulomatous inflammation within the eyelid. It arises from retained meibomian secretions. It is benign and often self limiting. It can occur in all age groups and is common in primary care.

  • Patients report a slowly enlarging lump with some variability in size on a day to day basis.

  • Ask about skin conditions which predispose to meibomian gland dysfunction—acne rosacea and seborrhoeic dermatitis.

  • Larger chalazions may be associated with visual symptoms. Ask about blurry vision from induced astigmatism or an awareness of visual field obstruction from mechanical ptosis.

  • Ask about pain, as this allows the chalazion to be differentiated from …

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