QuestionSBA
QuestionChoice
The clinical history and image are suggestive of a chalazion, caused by the blockage of an oil-secreting (Meibomian) gland. The first step in managing this condition is encouraging massage and using warm compresses.
10035427
a
Warm compresses and massage
QuestionChoice
Intralesional steroid injections are considered in persistent, recurrent chalazia. As this has only been present for a day, conservative management should be tried first. Incision and drainage may be preferred to steroid injections in the first instance.
10035431
e
Triamcinolone injection
QuestionChoice
Chalazia that do not respond to conservative management may require incision and drainage.
10035428
b
Incision and drainage
QuestionChoice
Chalazia are usually caused by non-infective processes (in contrast to styes). Although topical antibiotics are commonly used (especially for styes), the first line management to encourage the gland to unblock is massage and use of warm compresses.
10035430
d
Topical chloramphenicol
QuestionChoice
Chalazia are usually caused by non-infective processes (in contrast to styes). There are currently no indications for oral antibiotics. Flucloxacillin may be required if an infection develops.
10035429
c
Oral flucloxacillin
QuestionComment
Why can't this be peri-orbital cellulitis
53613
QuestionComment
There's not much in terms of risk factors for peri-orbital cellulitis, and the picture of the eyelid is mainly contained to the edge of the lid where the meibomian glands lie. The two differentials for chalazion are stye and blepharitis - and all these would be treated with warm compresses first line afaik.
58658
User
subscriber
Relapse Retrograde
User
subscriber
Edema Dominant
Concept
Chapter
2693
4637
Styes and chalazions
Topic
140
Ophthalmology
19489
A chalazion is managed initially with warm compresses and massage to promote drainage of the blocked Meibomian gland.
Picture
The typical appearance of a chalazion.
781
Chalazion.jpeg
images/s407pqrz1665036171706.jpg
images/s407pqrz1665036171706_256.jpg
images/s407pqrz1665036171706_512.jpg
oGkKFYQAVmd2dol5iHd4dwFmCFGG
A 19-year-old man attends the eye emergency department with a swelling of his eyelid. He is concerned that he has an eye infection as he admits to wearing his contact lenses in the shower. He has no visual disturbances.

On examination, his observations are within normal range, visual acuity (corrected) is normal, and eye movements are normal, as is fundoscopy. The following appearance is seen:

[lightgallery]

What is the most appropriate initial step in management?
a