What is a chalazion. How does it differ from a stye. What causes chalazions to form. How long can a chalazion last. What are the treatment options for chalazions. When is surgery necessary for chalazion removal. How can chalazions be prevented.

Understanding Chalazions: Causes and Characteristics

A chalazion is a benign bump that can develop on either the upper or lower eyelid. It occurs when a meibomian gland, responsible for secreting oil to prevent tear evaporation, becomes clogged. The resulting oil accumulation leads to the formation of a bump, which can range from small to quite large.

Chalazions are often confused with styes, but there are key differences:

• Chalazions are typically not infectious and tend to be chronic
• Styes are usually caused by bacterial infections and are acutely painful
• Chalazions can persist for days, months, or even years
• Styes generally resolve within a few days

Several factors can increase the likelihood of developing chalazions:

• Blepharitis (inflammation of the eyelids)
• Poor eye hygiene
• Frequent eye rubbing
• Blockage of meibomian glands due to infection, dust, foreign bodies, or trauma

Symptoms and Progression of Chalazions

How does a chalazion typically develop? The progression of a chalazion often follows a predictable pattern:

1. A small lump appears in the middle of the eyelid
2. The lump gradually grows, potentially reaching up to 1/2 inch in width
3. The skin over the lump may appear normal or slightly pink
4. The lump is usually not tender, unlike a stye

It’s important to note that while chalazions are generally not dangerous, they can lead to complications if left untreated. In some cases, particularly in children, picking at the chalazion can result in cellulitis, a potentially serious skin infection that may require oral or intravenous antibiotics.

Diagnosing and Treating Chalazions

Proper diagnosis of a chalazion requires examination by a healthcare professional. Once diagnosed, several treatment options are available:

Conservative Treatment Methods

• Warm compresses: Applied to open pores and promote oil drainage
• Lid scrubs: Used to reduce oil and prevent further chalazion formation
• Combination steroid/antibiotic ointments: Prescribed to decrease eyelid inflammation

How effective are these conservative treatments? When applied consistently, warm compresses and lid scrubs can be highly effective in managing chalazions, especially if treatment begins early. However, their effectiveness may diminish if the chalazion has been present for an extended period.

Surgical Intervention

When is surgery necessary for chalazion removal? Surgical intervention may be recommended in the following cases:

• The chalazion is very large
• The chalazion persists despite conservative treatment
• The chalazion has been present for 5-6 months or longer

The surgical procedure involves draining the chalazion and can be performed under local anesthesia for adults or general anesthesia for children. It’s important to note that while surgery can effectively remove an existing chalazion, it does not prevent future occurrences.

Preventing Recurrent Chalazions

For individuals prone to developing chalazions, preventive measures are crucial. What steps can be taken to reduce the risk of chalazion formation?

• Maintain good eye hygiene
• Use warm compresses regularly
• Perform lid scrubs as recommended by a healthcare professional
• Avoid rubbing eyes excessively
• Manage underlying conditions like blepharitis

Consistent application of these preventive measures can significantly reduce the likelihood of chalazion recurrence, improving overall eye health and comfort.

Chalazions in Children: Special Considerations

Chalazions in children present unique challenges and considerations. Why are chalazions in children of particular concern?

• Children may be more likely to pick at or rub the affected area
• The risk of developing cellulitis is higher in children
• Surgical intervention, if necessary, often requires general anesthesia

Parents and caregivers should closely monitor children with chalazions and seek prompt medical attention if there are signs of infection or if the chalazion persists despite conservative treatment.

The Role of Eye Care Professionals in Chalazion Management

Eye care professionals play a crucial role in the diagnosis, treatment, and management of chalazions. When should you consult an eye care professional about a suspected chalazion?

• If you’re unsure whether the lump is a chalazion or another eye condition
• If the chalazion is large, painful, or affecting vision
• If conservative treatments have not been effective after several weeks
• If you experience recurrent chalazions

Regular eye examinations can also help detect and address underlying conditions that may predispose individuals to chalazions, such as blepharitis or meibomian gland dysfunction.

Long-Term Outlook and Quality of Life Impact

While chalazions are generally benign, they can have a significant impact on quality of life. How do chalazions affect daily life and well-being?

• Cosmetic concerns due to the visible bump on the eyelid
• Discomfort or irritation, especially when blinking
• Potential vision obstruction if the chalazion is large
• Anxiety about recurrence in individuals prone to chalazions

Understanding the long-term outlook for chalazions is important for managing expectations and developing effective coping strategies. With proper care and management, most individuals can effectively control chalazions and minimize their impact on daily life.

Advances in Chalazion Research and Treatment

Ongoing research in the field of ophthalmology continues to enhance our understanding of chalazions and improve treatment options. What are some recent developments in chalazion management?

• Improved understanding of the role of meibomian gland dysfunction in chalazion formation
• Development of more targeted topical medications
• Exploration of minimally invasive surgical techniques
• Investigation into the potential use of light therapy for chalazion treatment

These advancements offer hope for more effective and less invasive treatments in the future, potentially reducing the need for surgical intervention and improving outcomes for individuals with recurrent chalazions.

As research progresses, it’s important for individuals affected by chalazions to stay informed about new developments and discuss potential treatment options with their eye care professionals. This collaborative approach can lead to more personalized and effective management strategies, ultimately improving eye health and quality of life.

What is a chalazion? Is it serious?

A chalazion is similar to a stye.  It is a bump the can be present on either eyelid.  Its size ranges from small to very large.  The glands that are present in the eyelids, called Meibomian glands, normally secrete oil that prevents the evaporation of tears from our tear film.  When these glands become clogged, a bump can form.  The surrounding oil can irritate the surrounding skin, causing inflammation.

Chalazions can last for days, months, even years.  Patients with blepharitis, a skin condition that causes inflammation in the lids, are predisposed to chalazia.  People with poor hygiene, who rub their eyes, are also more predisposed to styes and chalazia.  Although they are not dangerous, children can pick at them as well, causing a concurrent cellulitis.  Cellulitis can be dangerous if untreated with oral antibiotics.  Some people even need IV antibiotics to treat this condition.

There is a difference between a stye and a chalazion.   Most styes are caused by a bacterial infection and are acutely painful.  Chalazia are not typically infectious and are more chronic.

Warm compresses are frequently prescribed to open the pores of the Meibomian gland and promote drainage of the oil.  Lid scrubs are frequently used to decrease the amount of oil and prevent further formation of chalazia.  Combination steroid/antibiotic ointments are frequently prescribed to decrease the amount of inflammation on the eyelid.  If a chalazion is very large or persistent, surgery can be performed to drain the chalazion.  This procedure can be done under local anesthesia.  In children, it is often done under general anesthesia.  Surgery does not prevent chalazia from returning.  If a patient is predisposed to chalazia, it is important to prophylactically use warm compresses and lids scrubs to prevent recurrence.

If you are concerned you may have a stye or chalazion, please visit us at Sight MD.

Pediatric Advisor 10.

0: Chalazion (Lump on Eyelid)

It is not chalazion

Oman J Ophthalmol. 2013 Jan-Apr; 6(1): 63–69.

Abdullah Al-Mujaini

Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman

Buthaina Sabt

Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman

Ibrahim Al-Hadabi

¹Department of Pathology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman

Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman

¹Department of Pathology, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman

Correspondence: Dr. Abdullah Al-Mujaini, Department of Ophthalmology, Sultan Qaboos University Hospital, PO- 38, PC-123, Muscat, Sultanate of Oman. E-mail: [email protected]

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A 65-year- old woman, Omani patient, presented with a foriegn body sensation and a painless right upper lid swelling [] for over 6 months. Findings on everting the upper lid are as seen in .

Questions

1. What is the most likely diagnosis? Describe the clinical and histopathologic features [Figures and ] in support of your diagnosis.

2. What are the prognostic indicators in this condition?

Answers

Diagnosis

1. Sebaceous cell carcinoma, clinical [] and histopathologic features of pagetoid spread [], high lipid content [], and multifocal skip lesions support the diagnosis.

2. 1. Poor prognostic indicators:

      • Delay in diagnosis for over 6 months.

      • Size >10 mm.

      • Simultaneous upper and lower eyelid involvement.

      • Multicentric origin.

      • Poor differentiation.

      • Highly infiltrative pattern.

      • Vascular, lymphatic, orbital, and pagetoid spread.

   2. Good prognostic indicators:

Discussion

• Sebaceous cell carcinoma accounts for 1%–5% of all eyelid malignancies. Features mainly in 50 years and above age group, with a slight preponderance for females and Asians with the upper eyelid being the most common location. It presents as a painless, firm, slowly enlarging mass simulating a chalazion [], may masquerade as unilateral blepheroconjunctivitis, as a result misdiagnosis is reported in upto 50% both clinically and histopathologically. Sebaceous cell carcinoma is considered as an aggressive tumor with local versus metastatic spread.

Mortality rate is usually within 20% but increases dramatically to 59% when pagetoid extension exits. Treatment of choice for this type of cancer varies, but the most acceptable modality nowadays is Moh’s micrographic surgical procedure. It significantly lowers local and distant recurrence rates. Advanced cases will require exenteration, and in some cases palliative treatment with radiotherapy or chemotherapy may be required.

Chalazion – StatPearls – NCBI Bookshelf

Continuing Education Activity

Chalazia (plural of chalazion), are the most common inflammatory lesions of the eyelid. They are typically slowly enlarging, non-tender eyelid nodules. Chalazia are typically benign and self-limiting, though they can develop chronic complications. Recurrent chalazia should be evaluated for malignancy. This activity describes the cause, pathophysiology, presentation, and diagnosis of chalazion and highlights the role of the interprofessional team in its management.

Objectives:

• Describe the pathophysiology of chalazion.

• Review the presentation of chalazion.

• Summarize the treatment options for chalazion

• Explain the importance of improving care coordination among interprofessional team members to improve outcomes for patients affected by chalazion.

Access free multiple choice questions on this topic.

Introduction

A chalazion is a chronic sterile lipogranuloma. They are typically slowly enlarging and non-tender. A deep chalazion is caused by inflammation of a tarsal meibomian gland. A superficial chalazion is caused by inflammation of a Zeis gland. Chalazia are typically benign and self-limiting, though they can develop chronic complications.[1] Recurrent chalazia should be evaluated for malignancy.

Etiology

Chalazia are caused by inflammation and obstruction of sebaceous glands of the eyelids. While infection can cause the inflammation or obstruction that leads to a chalazion, the lesion itself is an inflammatory lesion.  

Epidemiology

It is a common condition, though the exact incidence in either the US or worldwide is not documented. It appears to affect males and females equally, but exact numbers are not available. Chalazia occur more commonly in adulthood (ages 30-50).

Pathophysiology

Chalazia are inflammatory lesions that form when lipid breakdown products leak into surrounding tissue and incite a granulomatous inflammatory response. For this reason, a chalazion is also called a conjunctival granuloma. Meibomian glands are embedded in the tarsal plate of the eyelids; therefore, edema due blockage of these glands is ordinarily contained to the conjunctival portion of the lid. On occasion, a chalazion may enlarge and break through the tarsal plate to the external portion of the lid. Chalazia due to blockage of Zeis glands are usually located along the lid margin.

Histopathology

Histopathology evaluation is rarely needed in the diagnosis and management of chalazia. If obtained, histologic examination reveals a chronic granulomatous reaction with numerous lipid-filled, Touton-type giant cells. Typically, the nuclei of these cells are located around a central foamy cytoplasmic area that contains the ingested lipid material. Mononuclear cells, including lymphocytes or macrophages, may also be found at the periphery of the lesion as this is an inflammatory process. If a secondary bacterial infection develops, then one could expect to find an acute necrotic reaction with PMNs.[2]

History and Physical

A chalazion usually presents as a painless swelling on the eyelid for weeks or months before the patient seeks medical treatment. Often a chalazion causes impaired vision or discomfort or becomes inflamed, painful, or infected. Frequently, the patient will have a history of previous similar lesions, as chalazia tend to recur in predisposed individuals.

Because chalazion is largely a clinical diagnosis, the chief complaint must be examined thoroughly to exclude other possible diagnoses, requiring a more involved workup. Typical history questions should cover the character of the lesion, the speed of onset, progression of the lesion, aggravating/alleviating factors, associated symptoms, and history of similar lesions. Lesions that recur in a particular location require workup to exclude carcinoma. Travel history is important to obtain as well, particularly patient visits to regions endemic for tuberculosis and leishmaniasis. Case reports have identified these as etiologies mistaken for chalazion.[3][4] Further history should be evaluated for visual changes, recent infections, recent antibiotics, skin infections, trauma to the lid, toxic exposures, immunocompromised status, history of cancer or history of/exposure to tuberculosis. Symptoms point to a diagnosis other than a chalazion include acute visual changes or eye pain that recurs in the same location, fever, extraocular movement limitations, and diffuse eyelid or facial swelling.

Physical findings consistent with chalazion include a palpable, usually non-tender (though in acute inflammation there may be some associated tenderness), non-fluctuant, non-erythematous nodule on the eyelid. The chalazion would be expected to be less than 1 cm in size. It presents more often on the upper lid as a single lesion, though multiple lesions are possible. Chalazia tend to be deeper within the lid than hordeolum. Hordeolum are usually tender, superficial, and centered on an eyelash. The eyelid should be everted as part of the examination to evaluate for an internal chalazion. Visual acuity should be assessed. If there is a pain of the globe, fluorescein staining can evaluate for an associated corneal abrasion.

Evaluation

The diagnosis of a chalazion is usually clinical. If history and examination are consistent, no further workup is required. If there is a question of an alternative diagnosis, a biopsy should be considered.

Treatment / Management

Conservative management is the initial strategy for chalazia.[5] Warm compresses should be applied to the affected lid for 15 minutes 2 to 4 times per day. Lid massage and possibly using baby shampoo on the lids can also be effective. Most chalazia resolve within one month with these conservative measures. If symptoms persist beyond one month, a referral to ophthalmology is recommended. There have been case reports of migration of the lesion with conservative management. [6]  If this occurs, referral to ophthalmology for surgical management is suggested. There is potential for larger central lesions to cause complications, so earlier referral for surgical management should be considered in these cases as well. Antibiotics are not routinely needed as this is an inflammatory condition. However, there may be times when an associated infectious etiology is suspected. If an infection is considered, tetracyclines are the antibiotics of choice. Doxycycline 100 mg by mouth twice daily for 10 days or minocycline 50 mg by mouth daily for 10 days would be reasonable options. In patients unable able to take tetracycline, metronidazole is the preferred alternative. If there is no evidence of infection, intralesional steroids could be used. Injection of 0.2 to 2 mL of triamcinolone 40 mg/mL solution would be a typical choice. Larger lesions may require a repeat injection in 2 to 7 days. Persistent lesions require surgical intervention. Smaller lesions may be treated with surgical curettage and dissection. Larger lesions require a more extensive excision. Recurrent chalazia should be biopsied to rule out sebaceous cell carcinoma.

Differential Diagnosis

While less common than chalazion, neoplasms must be considered, particularly in recurrent chalazia in the elderly. Carcinoma such as a sebaceous cell, basal cell, and squamous cell must be ruled out by biopsy if there is a clinical concern. Infectious etiologies such as blepharitis, dacryocystitis, herpes zoster, herpes simplex, molluscum contagiosum, Leishmaniasis, and cellulitis should be considered and treated when appropriate. Benign lesions such as papillomas, hordeolum, juvenile xanthogranuloma, and xanthelasma should be considered if appearance is not typical for chalazia. [7]

Prognosis

Prognosis is excellent for patients with chalazia. There is often resolution with conservative management.[8]

Complications

Untreated chalazia can predispose patients to preseptal cellulitis, which can lead to lid disfiguration with progression. Large central chalazia can cause visual disturbances due to the effects of direct contact with the cornea. Upper lid chalazion increases astigmatism and corneal aberrations, especially at the peripheral cornea. This risk is significantly increased by chalazion greater than 5 mm in size. Therefore excision of these lesions should be considered.[9][10]

Consultations

As discussed above, complicated, large or non-responding chalazia should be evaluated by an ophthalmologist. 

Deterrence and Patient Education

There is no specific preventive strategy for avoiding chalazia, although cleaning the eyelids regularly and using warm compresses are thought to have some preventative effects.  [11]

Pearls and Other Issues

Remember that chalazia themselves are an inflammatory, not an infectious process. Antibiotics are only indicated if there is evidence of an associated infectious process. The majority of chalazia respond very well to conservative management. Ophthalmology should be consulted for recurrent or refractory chalazia.[5]

Enhancing Healthcare Team Outcomes

Chalazia are often encountered in clinical practice by nurse practitioners, primary care providers, internists, and emergency department physicians. While the majority of these lesions can be managed conservatively, it is important to refer the patient to the ophthalmologist if the lesion is recurrent, infected or causing visual problems. Most healthcare professionals do not have the technical expertise to surgically manage these lesions. The prognosis for chalazion is excellent. Most resolve with conservative treatment.[5][12] (Level V)

Figure

chalazion of the upper eyelid. Image courtesy S Bhimji MD

Figure

A 28-year-old male presents with a “bump” that has been there for two weeks and one week before presentation, it drained a mucoid material on the inner side of the lid. The bump was painful but is no longer painful and the bump is smaller. This an example (more…)

References

1.

Jin KW, Shin YJ, Hyon JY. Effects of chalazia on corneal astigmatism : Large-sized chalazia in middle upper eyelids compress the cornea and induce the corneal astigmatism. BMC Ophthalmol. 2017 Mar 31;17(1):36. [PMC free article: PMC5374600] [PubMed: 28359272]

2.

Fukuoka S, Arita R, Shirakawa R, Morishige N. Changes in meibomian gland morphology and ocular higher-order aberrations in eyes with chalazion. Clin Ophthalmol. 2017;11:1031-1038. [PMC free article: PMC5460643] [PubMed: 28615923]

3.

Mittal R, Tripathy D, Sharma S, Balne PK. Tuberculosis of eyelid presenting as a chalazion. Ophthalmology. 2013 May;120(5):1103. e1-4. [PubMed: 23642745]

4.

Hanafi Y, Oubaaz A. [Leishmaniasis of the eyelid masquerading as a chalazion: Case report]. J Fr Ophtalmol. 2018 Jan;41(1):e31-e33. [PubMed: 29310954]

5.

Wu AY, Gervasio KA, Gergoudis KN, Wei C, Oestreicher JH, Harvey JT. Conservative therapy for chalazia: is it really effective? Acta Ophthalmol. 2018 Jun;96(4):e503-e509. [PMC free article: PMC6047938] [PubMed: 29338124]

6.

Chang M, Park J, Kyung SE. Extratarsal presentation of chalazion. Int Ophthalmol. 2017 Dec;37(6):1365-1367. [PubMed: 27942990]

7.

Carlisle RT, Digiovanni J. Differential Diagnosis of the Swollen Red Eyelid. Am Fam Physician. 2015 Jul 15;92(2):106-12. [PubMed: 26176369]

8.

Ozer PA, Gurkan A, Kurtul BE, Kabatas EU, Beken S. Comparative Clinical Outcomes of Pediatric Patients Presenting With Eyelid Nodules of Idiopathic Facial Aseptic Granuloma, Hordeola, and Chalazia. J Pediatr Ophthalmol Strabismus. 2016 Jul 01;53(4):206-11. [PubMed: 27182747]

9.

Aycinena AR, Achiron A, Paul M, Burgansky-Eliash Z. Incision and Curettage Versus Steroid Injection for the Treatment of Chalazia: A Meta-Analysis. Ophthalmic Plast Reconstr Surg. 2016 May-Jun;32(3):220-4. [PubMed: 26035035]

10.

Park YM, Lee JS. The effects of chalazion excision on corneal surface aberrations. Cont Lens Anterior Eye. 2014 Oct;37(5):342-5. [PubMed: 24890201]

11.

Arbabi EM, Kelly RJ, Carrim ZI. Chalazion. BMJ. 2010 Aug 10;341:c4044. [PMC free article: PMC2974575] [PubMed: 21155069]

12.

Görsch I, Loth C, Haritoglou C. [Chalazion – diagnosis and therapy]. MMW Fortschr Med. 2016 Jun 23;158(12):52-5. [PubMed: 27324006]

The Case of the Recurrent Chalazion

By Eva Devience, MD, and F. Lawson Grumbine, MD
Edited By Steven J. Gedde, MD

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After returning from a beach getaway, Carol Cooke,* a 35-year-old woman, felt irritation and a gritty sensation in her left lower eyelid. Remembering that a chalazion had been removed in that lo­cation 6 months previously, she booked an appointment for a chalazion consul­tation with our oculoplastics service.

We Get a Look

Ms. Cooke’s first visit with us was uneventful. Apart from the gritty sen­sation and chalazion removal, she had no ocular symptoms and no significant ocular or medical history. Her medica­tions included sumatriptan, as needed, for migraine and oral contraceptives. Uncorrected visual acuity was 20/20 in each eye. Her pupils were equal, round, and reactive. There was no afferent pupillary defect. Her ocular movements were full and without pain. Intraocular pressure was 18 mm Hg in each eye.

On slit-lamp examination, her right eye was normal. Her left eye showed mild meibomian gland disease and a 3-mm subconjunctival white lesion in the fornix. The overlying conjunctiva was intact. No ulcerations or discharges were seen. The rest of her left eye exam was unremarkable.

Initial Misdiagnosis

At the time of her chalazion removal 6 months earlier, the outside physician ordered a biopsy, which confirmed the diagnosis of chalazion. With a small, white, postprocedural subconjunctival lesion in the setting of a biopsy that was negative for malignancy, our work­ing diagnosis was a scar. We discussed with Ms. Cooke that a scar should improve or at least remain unchanged over time. We arranged for follow-up in a few weeks, with plans for repeat biopsy if the lesion had grown larger.

However, she returned 2 weeks later complaining of a rapidly enlarging mass with yellow crusting and dis­charge. The mass was now 1.3 × 1.0 cm in the anterior orbit, eroding through the conjunctiva. Her bulbar conjunc­tiva was now edematous and injected (Fig. 1). Her motility remained full, and there was no globe displacement.

Differential Diagnosis

Given the atypical presentation and rapidly progressive nature of the lesion, our concern was for an aggressive neoplasia, although an infectious or inflammatory process was also in the differential. Her history of chalazion and the lesion’s proximity to the lid margin made us consider sebaceous cell carcinoma, although the intact eyelid margin made it less likely. There were no eyelid or local skin lesions to suggest basal or squamous cell carcino­ma of the eyelid. If the primary tumor had arisen from the conjunctiva, the ulcerated lesion would certainly raise concerns for ocular surface squamous neoplasia (OSSN), the most common malignant neoplasm of the conjunctiva; however, the orbital location was quite atypical, as intraorbital spread is an un­common initial presentation. Another possibility was lymphoma, in which the tumors are typically salmon colored and can be a sign of systemic lympho­ma. Finally, vascular tumors may occur after chalazion excision.

A Repeat Biopsy

An incisional biopsy of the mass showed moderately differentiated squamous cell carcinoma (Fig. 2A). Magnetic resonance imaging (MRI) of the orbits with contrast was ordered to define the extent of the lesion (Fig. 2B). This demonstrated a 1.5 × 1.0 × 0.7–cm contrast-enhancing mass abutting the globe. Given that HIV/AIDS is a risk factor for OSSN, we ordered an HIV test, which was negative.

Treatment

A few days later, we performed an anterior orbitotomy for tumor excision with margins. While excising margins, it was noted that the tumor was tightly adherent to the eyelid, so we also per­formed a wedge resection of the piece of eyelid at the anterior margin, fol­lowed by a membrane graft reconstruc­tion. Ms. Cooke’s pathology revealed a 1.3 × 0.9 × 0.3–cm gross squamous cell carcinoma specimen, most likely of conjunctival origin. All of her margins (including her eyelid) were negative.

Postoperatively, we had extensive discussions with Ms. Cooke about the next steps. Although her tumor was completely excised with negative margins, we were concerned about mi­croscopic residual tumor cells, because it had already seeded deeper into the anterior orbit by the time she presented to us. After a multidisciplinary tumor board discussion with radiation on­cology, we offered Ms. Cooke electron beam radiation as adjuvant therapy. This has a shallower penetration than conventional X-rays, affording the abil­ity to deliver high-dose radiation to the anterior orbit while sparing the retina and optic nerve. Based on pretreatment simulations, the predicted side effects were dermatitis, conjunctival scarring, and cataract that may occur 2 to 3 years afterward. Her visual acuity should be otherwise preserved.

About the Diagnosis

A wide spectrum of disease. OSSN is an umbrella term for a spectrum of dysplastic and malignant epithelial lesions of the conjunctiva and cornea. OSSN lesions involving only the epithe­lium may be termed conjunctival squa­mous neoplasia.¹ Risk factors include ultraviolet light exposure, human pap­illoma virus (type 16) infection, HIV/AIDS, and xeroderma pigmentosum.

Histology determines the OSSN spectrum:

• Grade 1, conjunctival epithelial dys­plasia: Dysplastic cells are confined to the basal layers of the epithelium.
• Grade 2, carcinoma-in-situ: The lesion involves the full thickness of the epithelium.
• Grade 3, squamous cell carcinoma: Invasive disease is present.

Presentation. The most common presentation of OSSN is an elevated, vascularized lesion in the limbal region of older patients. Ms. Cooke’s orbital mass was an unusual presentation.

Treatment. OSSN is typically treated with wide surgical excision and, to reduce recurrence, adjunctive tech­niques (e.g., application of alcohol or cryotherapy). One should refrain from direct manipulation of the tumor to avert microscopic seeding to other ocu­lar structures (“no touch” technique).

Recently, there has been a paradigm shift in the treatment approach to OSSN.² Clinicians may now use topical chemotherapy as both adjunctive and primary therapy. Topical mitomycin C, 5-fluorouracil, and interferon alfa have been shown to be effective. Galor et al. advocated adjuvant interferon therapy in patients with high-risk characteristics after surgery—namely, positive margins, tarsal involvement, or recurrent disease.² Radiation therapy or enucleation remains reserved for those with intraocular or orbital invasion and systemic metastasis, which fortunately are uncommon in OSSN.¹

Recurrence. Positive surgical mar­gins have long been identified as a risk factor for recurrence, with some series showing that excised lesions with neg­ative surgical margins had a recurrence rate of 5%, compared with 53% for those with positive margins. ³

Patient’s Progress

Ms. Cooke chose to undergo electron beam radiation adjuvant therapy after excision, and she has done well thus far. She developed mild radiation derma­titis of the eyelid, but her vision has remained 20/20 and her oral mucous membrane graft has remained intact. There have been no signs of recurrence. She is also undergoing a genetics consultation, given her relatively young age at the time of diagnosis.

Reviewing her outside hospital records, we wondered whether she had had a chalazion at all. We obtained her initial pathology slides, which were first read by a general pathologist. A second evaluation by an ocular pathologist was read as conjunctival squamous cell carcinoma. Most likely, the “chal­azion” removal seeded this carcinoma into the deeper orbit where it grew into an orbital mass. Ms. Cooke’s case is a reminder to question a prior diagnosis if the presentation is atypical or there is concern for a malignant lesion.

___________________________

* Patient name is fictitious.

___________________________

1 Kim JW, Abramson DH. Clin Ophthalmol. 2008;2(3):503-515.

2 Galor A et al. Ophthalmology. 2012;119(10):1974-1981.

3 Erie JC et al. Ophthalmology. 1986;93(2):176-183.

___________________________

Dr. DeVience is a second-year ophthalmology resident and Dr. Grumbine is an oculoplastics surgeon and assistant professor; both are at the University of Maryland in Baltimore. Relevant financial disclosures: None.

Three Pillars of Chalazia Management

A 66-year-old woman presented complaining of a large, painless lump in her left upper lid that developed rather rapidly over several days beginning two months earlier. Though the lesion was painless now, she did experience some moderate pain while it was developing. She had been putting hot water on it to no avail.

Evaluation

Her best-corrected visual acuity was 20/20 in each eye. The remainder of her examination was normal, except for biomicroscopically visible crusting about the eyelashes, blocked meibomian glands and a grossly visible, painless, hard, focal lump in her left upper eyelid. Based upon appearance and history, it was clear that she had developed a chalazion, most likely secondary to chronic blepharitis. There are several options for treating this patient and virtually every doctor has a “favored” approach to managing chalazia. However, does the science support any or any of these “can’t-miss” treatments?

Conservative Therapies

Chalazion is a common inflammatory condition of the eyelid. Two patterns of granulomatous inflammation represent the spectrum of changes in its clinical course. Mixed-cell granulomas consisting of neutrophils, lymphocytes, plasma cells, macrophages, giant cells and granulation tissue may be present. ^1,2 Additionally, you may see suppurating granulomas characterized by epithelioid cell granulomas with numerous neutrophils in a proteinaceous background.^1,2 The cells involved in these lesions are steroid sensitive.^1,2 

Chalazia (plural of chalazion) are typically caused by blockage of the meibomian glands and chronic lipogranulomatous inflammation. It can affect patients of any age, race or gender. Common complaints are poor cosmesis, local irritation and, in cases of large lesions, mechanical ptosis and corneal astigmatism.³

Conservative management can include lid scrubs (either with baby shampoo or commercially prepared scrubs), hot compresses with or without digital massage, topical antibiotic solutions and ointments, oral antibiotics or a combination of antibiotic or steroid solutions and ointments.^4-6 However, the effects of these approaches aren’t always clear. One study shows simple lid hygiene resulted in clinical chalazia cure in 80% of cases. ⁶ Another shows hot compresses and lid hygiene together had a 43% cure rate.⁵ In a 2006 investigation hot compresses, lid hygiene and antibiotic ointment QID, shows a 58% cure rate.⁴ 

More recent research looked at 149 patients with one or more chalazia on separate eyelids and randomized them to receive therapy involving hot compresses only, hot compresses plus tobramycin drops and ointments, and hot compresses plus tobramycin/dexamethasone drops and ointment over four to six weeks. Treated with hot compress alone, 21% saw complete lesion resolution. Adding tobramycin drops and ointments to hot compresses worked out for 16% of subjects and hot compresses plus tobramycin/dexamethasone drops and ointments helped 18% achieve resolution. ⁷ 

None of these differences in treatment could be considered significant. Lesions that completely resolved had a statistically significant lower pretreatment duration of 1.5 months compared with lesions that did not completely resolve with lesions present over 2.2 months. This report shows that hot compresses alone or in combination with tobramycin or tobramycin/dexamethasone drops and ointment are all effective first-line treatments; however, lesions present longer than two months are less likely to resolve with these conservative therapies alone.⁷

While “conservative” therapies are non-invasive and exceedingly safe, they clearly do not work for every patient. 

Steroids

The inflammatory cells that comprise chalazia are steroid sensitive, which is why some research is considering intralesional steroid injection as a management option.^2-11 Intralesional injection involves the injection of 0.1ml to 0.3ml of triamcinolone actetonide (5mg/ml to 40mg/ml) from a conjunctival approach. ^3,4,8 Like conservative therapies, no clear delineations as to the optimal amount and concentration of steroid exist. However, the success rates for this management modality is typically higher than for conservative therapy.^4-9 A 2006 study saw a 94% cure rate (vs. 58% for conservative therapy) with intralesional injection of triamcinolone.⁴ Another investigations achieved an 80% success rate after two injections.⁹

While intralesional injection of triamcinolone is generally safe, significant complications can occur. Skin depigmentation is a common occurrence following intralesional injection in dark-skinned patients.^4,9,11 Also, inadvertent globe perforation is a possibility.¹² Rarely, microembolization by steroid particles can result in retinal and choroidal infarction with subsequent permanent vision loss.¹²

Surgery

Incision and curettage remains an option. The lesion can be surgically removed, typically through a palpebral conjunctival approach, with the use of scalpel and chalazion clamp following an injection of anesthetic. Thermal cautery is often performed immediately following surgical excision, but this is typically the surgeon’s choice, as it does not appear to reduce recurrence rate.¹³ Cure rates with surgical excision are between 90% and 100%, though more than one surgery may be necessary.^8,9 Surgical excision is typically the recommended procedure for lesions that are larger than 11mm and chronic (lasting more than eight months).² 

While highly successful, surgical excision also has potential complications. If excision goes through the dermis, scarring is possible. Further, inadvertent globe perforation may occur during chalazion excision.¹⁴ Surgical excision remains an option if conservative or intralesional injection fail to resolve the condition.

Comparing intralesional steroid injection to surgical curettage in a meta-analysis, researchers found that for a single procedure, surgical curettage was more successful than steroid injection at achieving resolution. ¹⁵ If multiple procedures were necessary, then the difference in success between steroid injection and surgical curettage was reduced.¹⁵

Intralesional steroid injection and surgical curettage shows similar results.¹⁶ A single triamcinolone acetonide injection followed by lid massage is almost as effective as incision and curettage.¹⁷ A study of chronic chalazia that were unresponsive to medical treatment, noted that lesions responded well to both steroid injection and surgical curettage.

In our case, conservative therapy with hot compresses alone was recommended. Due to her skin pigmentation, steroid injection was not advocated. Ultimately, conservative therapy did not result in any significant improvement and she underwent successful surgical excision. 

Eyelid lumps

Styes

A stye is an infection in the edge
of the eyelid. The infection is in a gland at the base of an eyelash,
and is usually caused by staphylococcal bacteria. The treatment you need
depends on how severe the infection is. See

A photograph of an early stye explanation

Treatment of styes

Meibomian Cysts (chalazions)

See chalazion. Meibomian cysts (or ‘chalazions’)
have different stages. If your eyelid has a small lump in, and is red,
painful, and swollen, treat like a stye as above. Meibomian cyst is the name given to a lump in the eyelid; this lump may
consist of debris remaining after an infection blocking the gland. Once
the main infection has subsided, they do not grow bigger, and are then
not very red or painful.

Nearly all the chalazia/lumps disappear naturally in about
8-16 weeks or a lttle longer. See

a chalazion that has been
present some time (best having minor surgery)

The only exceptions are the hard and firm chalazia, and if the lump does not disappear naturally, it can be removed
by a small operation in the eye clinic (special funding is required from GPs surgery, and this is often not available). The doctor injects a little local
anaesthetic into the eyelid to make it feel numb.

The cyst is then scrapped out. Sometimes the shell of the cyst is
very thick, and the doctor may be able to scrape out the contents,
but the shell cannot be removed. If this happens, a small lump may
remain in the eyelid. Very occasionally a second operation may help. The operation may cause bruising of the eyelid. If it does, the bruising
may take about a week to go. Usually a tiny cut is made on the inside
of the eyelid, so there is no scar. If the lump is just under the skin,
the doctor may make a tiny cut in the skin.

acute chalazion
needing hot bathing and antibiotic cream (possibly tablets as well)

a recent acute chalazion: this
is likely to settle without surgery

Preseptal Cellulitis adults

If not allergic to penicillin, adults :

1. webmd. com/eye-health/periorbital-cellulitis     eyewiki.aao.org/Preseptal_cellulitis
2. co-amoxyclav 325 mg 3 times a day 1 week
3. alternative if penicillin allergy or flucloxacillin unsuitable: clarithromycin or erythromycin (in pregnancy).
4. Hot bathing (not too hot to burn)
5. occ chloramphenicol 4 times a day 1 week

Recurrent chalazions:
prevention

If you develop chalazions quite frequently, preventative
treatment may be helpful see.
Chalazions may be caused by blockage and infection of the glands in the
eyelids. Some people who develop frequent chalazions have dry skin, with secretions
blocking the glands.

Treatment that unblocks the glands in the eyelid may help stop more
chalazions developing. To prevent the glands blocking, (see blepharitis page):

Very brief

1. Heat compresses and massage twice a day
2. Blephaclean or blephasol twice a day
3. Preservative free lubricant
4. vitaPos night

More details

• The cleaning helps to reduce
  the number of bacteria in the glands of the lid. This is the same treatment as for blepharitis and reduce all sorts of lid problems.

Gently clean
with Blepharaclean wipes ( or a cotton bud if unavailable), looking in mirror, pull the lower eyelid down with the index finger
of one hand, and gently but firmly wipe the wipe or bud along the edge of the
lid to scrape the debris off.
With your chin up try the same on the upper lid, but this is harder.

• Cleaning: clean lids with Blepharaclean wipes (these can be bought or obtained from a doctor’s prescription, or if unavailable a cotton bud).
  Clean the edge of the eyelids
  (the eyelash edge) with the wipe or wet cotton bud. Gently scrape off the debris
  moving the wipe/bud side to side. If using a bud, warm tap water is usually
  quite safe. The Blepharaclean wipes are probably more effective.
• Bathing: warm compresses with an ‘Eyebag’ hot compress: these can be bought or obtained on prescription, and one lasts a long time (or similar compress, there are may brands). If you don’t have a compress or a microwave, use clean face cloth soaked
  in warm water, as hot as your eyelids can stand. Bath the eye (closed)
  for 5-10 minutes. Re-warm the cloth if it gets cold. This makes the
  debris easier to remove, as below.
• massaging: gently pull the low lid down and (using a mirror) gently press on the lid margin moving fingers over the bone under the lid. (see text   YouTube video) WIth the upper lid this is much harder ..try to gently press on the upper lid. Repeat this over 30 seconds. Try to express he secretionsin the glands by massaging towards the edge of the lid.

1. If the cleaning is not helpful preventing the chalazions, antibiotic
   ointment may help. Your GP will need to prescribe it; try it for 3
   months (chloromycetin or fucithalmic).
2. A healthy diet with omega 3 (or flaxseed oil) and plenty of vegetables
   and often very important.
3. Sometimes chalazions return once the ointment is stopped, and you
   may need a repeat prescription from your GP. Some people benefit using
   the cream intermittently.
4. Finally, if all else fails and you still develop more chalazions,
   a course of antibiotic tablets may help in adults who are not pregnant, such as doxycycline 50-100mg
   daily for three months (from your GP). The benefit of antibiotics lasts several months after stopping treatment,
   but if the condition returns you may need to use further courses. Erythromycin for 2 months or so helps children.

   This treatment is sometimes
   useful if the other treatments do not work. It is particularly effective
   if you have a skin condition, such as acne rosacea, or very dry skin,
   or if the edge of your eyelid stays red with many scales.
   
   Antibiotic tablets are NOT suitable for everyone, particularly if you
   use several other tablets or have stomach problems. You will need to
   discuss this treatment with your GP first. See excellent article for BMJ
   subscribers   BJO 2011

Cysts of moll

These are tiny cysts with fluid inside. They
do not grow. After a local anaesthetic injection, a small nick is made
in the cyst. The skin of the cyst is also removed. Usually they do not
recur.

Papillomas

Papillomas can grow to different
sizes. They are probably caused by a virus, and are essentially warts on
the skin.

They are removed in a ‘minor operations’ clinic in the eye department.
Your skin is anaesthetised with a small injection. The papilloma is then cauterised.
Usually a little scab forms, and heals in a week, leaving a nearly invisible
scar.

If the papilloma is near the edge of the eyelid, the scar may make the
edge a little crooked. They may recur after the operation, which may need to
be repeated.

Melanoma

   Lesions with any of the major or three of the
minor are suspicious of melanoma BMJ:

 Entropian

• link
• entopians of upper lid..? pemphigoid or trachoma
• lower lid…? chronic conjunctivitisl
• leaflet and taping

Ectropian 

• lateral…eczema, sun, allergy
• normally medial

Funding 

• Chalazions. .. put on authorisation form ‘conservative treatment has failed’ ideally try for 6 months.
• Any suspect cancers or recurrent chalazions which are effectively suspect cancers do not need authorisation, do write in notes surgery/ biopsy to exclude cancer to avoid refusal.

Sturge-Weber Syndrome

90,000

answers – answers of doctors of the Cosma clinic

Ask a Question

April 21, 2015

Hello! My daughter is 9 months old. I will not cancel breastfeeding. Everyone says it’s time to wean you from daytime. When and how to wean from breastfeeding. Thank you)

21.04.2015

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April 14, 2015

Hello! Tell me, do you have a child psychiatrist? Thanks.

04/14/2015

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April 10, 2015

Hello! Disturbed by headaches, pressing the bridge of the nose, eyes. It is hard to hold your head, especially when leaning forward. Severe spasm of the trapezius muscles, the muscles of the clavicle on the left are swollen, pulls the left shoulder blade and lower back on the left. Painful point on the scapula, radiating to the collarbone, arm and back of the head.X-ray: posterior spondyllolisthesis c4-c5, rotation of bodies c6-c7-d1 to the right. MRI of the cervical spine: chronic subluxation c1, right-sided paramedian herniated disc c3. The exacerbation began after stress, I think the vertebrae were knocked out due to muscle spasm. How can you help in my situation. I would like to get an appointment with V.I. How many sessions will it take? Is the doctor using a gentle technique? Thanks!

10.04.2015

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07 April 2015

Hello! What method is used to remove moles, a histological analysis of the removed material is done, and a dermatoscope is used? Thanks.

07.04.2015

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06 April 2015

Hello! Question to oncologist T. S.Grigorieva. – what method is used to remove moles (radio wave, laser, etc.), is it used in the diagnosis of a dermatoscope, is a histological examination of the removed mole done? Thanks.

04/06/2015

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05 April 2015

Hello! My daughter is 1 year old with severe muscle hypertonicity. At the moment, there are no visible deviations, the child went to 11 months, the development corresponds to the age.Disturbed by frequent night waking up. Our homeopath suspects cervical problems. I wanted to show the child to Dr. Kosmirov. Tell me how many sessions your daughter needs to go through, with what frequency. I need to find out whether I can pull financially.

05.04.2015

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04 April 2015

How to choose night lenses, their price and for how long?

04.04.2015

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02 April 2015

Hello! My daughter is 2 years old.Have put the displacement of the cervical vertebra during childbirth. We are from the city of Tuymazy, we were advised to contact you. I would like to sign up and inquire about payment. How to do it?

02.04.2015

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March 30, 2015

My son has complex hyperopic astigmatism. Do they take with such a vision to a military school?

03/30/2015

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March 26, 2015

Hello. My five-year-old daughter started having some kind of nocturnal seizures.At first he calmly falls asleep, and then begins to grind his teeth, rushing about on the bunk. It calms down for a while and starts anew. Tell me what to do. Waiting for your reply. Thank you in advance.

03/26/2015

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13 March 2015

Hello! Are you worried about the city of Uralsk, Kazakhstan, is it possible to come to you and undergo an examination in two days?

03/13/2015

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12 March 2015

Hello. My daughter is 4 years 8 months old and we very often suffer from cough (mostly it is wet with phlegm), we sit on sick leave for a month and the cough goes away for a very long time. Now the situation is the same – the cough does not go away for more than a month, at first it was wet, the sputum left, but after two weeks it became dry for some reason … Now, of course, it has already become better, but still the coughing has remained, and when my daughter eats something, Something also begins to cough, before this was not the case. I am worried that the cough does not go away for so long … Tell me, do we need to contact you with such symptoms? Or do you need a consultation from another specialist, maybe a pulmonologist? I just don’t know which specialist to turn to.Thank you in advance.

03/12/2015

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03 March 2015

Good afternoon. I have a question. Daughters 5.5 years old, about 4 months ago began to observe such a picture in her behavior. For example, when we come home from the garden, she begins to say that she does not know how to undress, asks her to undress or bring clothes (respectively, I say that she is already big and can do it herself) or, as an option, wants to tell something at that moment when adults are talking and realizing that they are not listening to her, she rolls a tantrum: she knocks her feet, claps her hands, screams and even squeals (while all this is forcibly squeezed out of herself, and there are no tears as such). Increasingly, any refusal in her request begins to be accompanied by tantrums. When asked to calm down, he starts to hysteria even more … Please tell me how to be in such a situation and whether it is necessary to consult a psychotherapist or it can be solved at the level of relationships. Pregnancy went a little nervous, as there were problems with her husband. From 5.5 months to the present, I am raising my daughter alone. Thanks!

03.03.2015

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February 27, 2015

Hello! The doctor prescribed DUFASTON tablets to me to normalize the menstrual cycle.Drink 1 t. 2 rubles. on the day from 14 to 25 days of the cycle, and I want to get pregnant. I read on the Internet that if you quit drinking them, your period comes (or a miscarriage, if the pregnancy has nevertheless come), and if you continue to drink them, then the pregnancy will persist and you need to drink them until the 20th week of pregnancy. How then is it correct to take these pills if I want to get pregnant.

27.02.2015

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February 25, 2015

Hello. Can a proctologist admit a teenage girl in your clinic?

25.02.2015

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12 February 2015

Hello, last year I was tested for infections in “Science”, they found ureaplasma urealiticum 10 in 4, the doctor prescribed treatment with unidox solutab, trichopolum and metronidazole, and even after these drugs, viferon suppositories. I drank everything, passed the analysis in the same place after 2 months, nothing has changed. Recently I passed the analysis in “Citylab” to determine the microflora of vaginal discharge. Corynebacterium amycolatum (sensitive to amoxicillin, tetracycline, ciprofloxacin) and enterococcus faecalis (sensitive to ampicillin, ciprofloxacin, penicillin, streptomycin) were found.Which laboratory to believe and how to deal with these analyzes? Vaginal discharge is troubling. Thanks for the answer.

12.02.2015

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February 10, 2015

Good afternoon, a question for the doctor V. I. I have been sick with stomach cancer since the beginning of 2013. In June 2013, the stomach was removed with a diagnosis of T4N1M0. Exactly one year later, ascites in the abdominal cavity and carcinoma were found. Now, after the courses of chemotherapy, I have problems with swelling of my legs. Can you tell me anything you can help me.Thank you in advance.

10.02.2015

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February 10, 2015

Good afternoon! How can you remove a nevus 3 * 1.5, a child of seven months, on the face? Where can you delete it?

10.02.2015

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09 February 2015

Hello. My son, 6 months old, sat down by himself, after about a week or two, he began to stand on his legs holding on to his hands. Holding on, worth it. Is not it too early?

09.02.2015

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06 February 2015

Good afternoon! A question for a neurologist.Help assess the correctness of the treatment! The son was born with a perinatal CNS lesion. They set intrauterine hypoxia and had a long, difficult labor, lay in intensive care. Now he has a syndrome of motor disorders, he is weak enough, he does not hold his head from a supine position, but he actively walks and smiles. They took Elcar, Encephabol, Actovegin injections, a massage and physiotherapy sessions, now they prescribed Corylip-neo suppositories and a tsonnorezin tablet. Is this enough and are these pills not harmful? Do you need additional treatment? We are now 2.5 months old.

02/06/2015

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06 February 2015

Question to Galina Leonidovna Znamenskaya. Please decipher the results of neurosonography of my son 2 months old: the lateral ventricles are not dilated, the left is 2-2-6, the right is 2-2-5, the third is 3.3 mm, there are no focal changes, the interhemispheric fissure is 3.5 mm deep up to 15 mm, subarachglidal space by convex up to 2 mm. According to the results of Doppler: anterior cerebral artery Vs 88, Vd 28, Ri 0.69, basilar artery Vs 99, Vd 34, Ri 0. 66, velocity along the vein of Galen 14; vertebral arteries on the left in the V2 segment 0.86 (Vs 43, Vd 6), in the V3 segment 0.90 (Vs 116, Vd 11), on the right in the V2 segment 0.84 (Vs72, Vd 11), in the V3 segment 0, 89 (Vs 109, Vd 12).Conclusion: PA spasm. Now we are 2.5 months old, he does not turn on his side, he does not hold his head from a supine position, he does not hold his head upright, he walks upright, smiles, we put toys, but he does not hold, he can grab diapers and hair, is active, but shudders in a dream. We completed a course of massage and physiotherapy (exercises on the ball, ultrasound on the neck, pressure chamber), Actovegin, now we are drinking cinnarizine. Is this enough or is there any further treatment needed? He also turns his head mostly to the left and draws in his neck.Really looking forward to the answer!

02/06/2015

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05 February 2015

Hello! Today, when changing the diaper (my son is 9 months old), I noticed white discharge, no redness or swelling on the penis. As I understand it, this is a natural lubricant. Do I need to see a doctor? To which? Or is it just more careful hygiene?

05.02.2015

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02 February 2015

Hello, Vitaly Ivanovich. My daughter is 10 years old – progressive myopia (-3.75 and -4.5 points) often has a headache.X-ray showed instability of the S-section vertebrae (the displacement of the vertebrae relative to each other at the level of C3-C6, the height of the m / n discs is preserved, and scoliosis is 2 degrees (13 degrees). Could this affect the deterioration of vision? (In the Eroshevsky hospital in the summer will offer scleroplasty surgery) .Can you do something? Thank you.

02.02.2015

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January 25, 2015

Hello Vitaly Ivanovich. I was at your reception recently. You have prescribed homeopathic treatment for Staphysagria (Delphinium) C30, Konium C30, Tuya C30.Found out about 6 weeks pregnant. Tell me, can I use these drugs during pregnancy? Thanks!

25.01.2015

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January 23, 2015

Hello. My daughter is 8 months old. She pulls her legs up to her tummy, begins to push hard, blushes, squeezes her hands into her fists, inflates and deflates her tummy. Can you please tell me what to do about it? Pooping is good.

01/23/2015

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January 22, 2015

Hello! Please tell me how much does the operation to remove the fibrioma of the left hand of the index finger in a child cost?

22.01.2015

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January 22, 2015

Hello. My daughter has an asymmetry of the face, on the right side of the forehead protrudes more than on the left. She is 1 month old. Can this be corrected and which doctor should I go to?

01/22/2015

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January 18, 2015

Hello! My son is 9 months old. First childbirth, natural at 38 weeks, rapid. From 1 month, the diagnosis was the syndrome of movement disorders, PPTSNS. According to the results of NSG at 5 months – Cyst of the right choroid plexus, echographic signs of hydrocephalic syndrome.According to the Doppler ultrasonography of the vertebral arteries at 6 months, there was a slight pathological tortuosity of the PA on the left. 4 courses of professional massage, a course of electrophoresis, magnetotherapy were completed. The baby began to turn from back to stomach at 6.5 months, from stomach to back at 9 months, to sit at 7.5 months, does not get up on all fours, does not crawl, does not get up in bed, restless. Should we go to a pediatric osteopath and how many sessions does a treatment course consist of on average? Or is it worth being treated further by a neurologist? Who should we contact? Thank you in advance!

18.01.2015

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January 15, 2015

Do you treat children with congenital dysplasia of the hip joint with clubfoot? Question to Dr. Kosmirov.

15.01.2015

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December 24, 2014

Hello, my son’s upper eyelid chalazion (for 1.5 months) was treated with drops and floxal ointment for 7 days.

24.12.2014

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Prices for ophthalmology at the Sakara Medical Center

Cost of services | DoctorVisus.ru

No.
Service
Price

1

Diagnostic program with subsequent consultation chap.doctor of the clinic, doctor of the highest category, doctor of medical sciences Nazarova G.A.
(autorefractometry, visual acuity, glasses selection, IOP-pneumotonometry and according to Maklakov, ORA, computer field of view, CFMC, gonioscopy, central corneal thickness, fundus examination – reverse ophthalmoscopy) * Except for pensioners, disabled people of groups I and II and dispensary patients

5,000 rub

2

Diagnostic program with the subsequent consultation of the professor, Dr.M.Sc. Alekseeva I.B.
(autorefractometry, visual acuity, glasses selection, IOP-pneumotonometry and according to Maklakov, ORA, computer field of view, CFMC, gonioscopy, central corneal thickness, fundus examination – reverse ophthalmoscopy)

8 500 rub

3

Diagnostic program with subsequent consultation, doctor of the highest category, Ph.D. Vasina M.V.
(autorefractometry, visual acuity, glasses selection, IOP-pneumotonometry and according to Maklakov, ORA, computer field of view, CFMC, gonioscopy, central corneal thickness, fundus examination – reverse ophthalmoscopy) * Except for pensioners, disabled people of groups I and II and dispensary patients – 10% discount

5 800 rub

4

Diagnostic program with subsequent consultation, doctor of the highest category, Ph.M.Sc. Vasina M.V. for seniors
(autorefractometry, visual acuity, glasses selection, IOP-pneumotonometry and according to Maklakov, ORA, computer field of view, CFMC, gonioscopy, central corneal thickness, fundus examination – reverse ophthalmoscopy) * Except for pensioners, disabled people of groups I and II and dispensary patients – 10% discount

4800 rub

5

Diagnostic examination before refractive operations, surgical treatment of keratoconus
(autorefractometry, visual acuity, selection of glasses, IOP pneumotonometry, keratotopography, keratopachymetry, aberrometry, elevation keratotopography using Pentacam, fundus examination, doctor’s consultation)

4 500 rub

6

Diagnostic program for adults
(autorefractometry, visual acuity, selection of glasses, IOP, cchsm, visual fields, fundus examination, doctor’s consultation)

3 500 rub

7

Diagnostic program for children with subsequent consultation of the head physician of the clinic “Doctor Visus”, doctor of the highest category, d.M.Sc. Nazarova G.A.
(autorefractometry with a narrow and wide pupil, visual acuity, selection of glasses, IOP-pneumotonometry, PZO, fundus examination – reverse ophthalmoscopy)

3 800 rub

8

Diagnostic program for children
from 5 years (autorefractometry with a narrow and wide pupil, visual acuity, selection of glasses, IOP-pneumotonometry, PZO, fundus examination – reverse ophthalmoscopy, doctor’s consultation)

2 800 rub

9

Diagnostic program for children
from 0 to 5 years (examination by a pediatric ophthalmologist)

3 800 rub

10

Dispensary examination for glaucoma, after cataract surgery and after refractive surgery and other categories of dispensary patients
from 3 to 6 months

1 800 rub

11

Diagnostic programs for glaucoma, cataract for retirees

2 500 rub

12

Diagnostic programs for glaucoma, cataract for disabled people of I and II groups

2 300 rub

13

Selection of glasses (simple, non-progressive)

1 200 rub

14

Dispensary examination against the background of the use of optical correction (without corneotopography and biometrics)

2 500 rub

Usługi

WHAT IS REFRACTIVE SURGERY?

This is an operation aimed at correcting visual impairment.It is performed using a laser.

SCHWIND AMARIS® 500E Excimer Laser

This laser is one of the world’s leading high-tech leaders in the field of laser vision correction. Our clinic has been equipped with such a laser since May 2019. Thanks to the use of modern technologies, the procedures are safe, short-lived and painless.

With this laser we can correct visual impairments in the range from -12.0 (myopia) to +6.0 (hyperopia) spherical diopters and up to 6.0 cylindrical diopters (astigmatism).

This laser allows you to perform operations such as:

• laser vision correction, all available treatments in conjunction with SmartSurfe (TransPRK),
• laser correction based on WaveFront,
• PresbyMax – a unique platform for laser correction of presbyopia,
• PTK – module for planning the treatment of scars and corneal dystrophy using elliptical or circular tissue ablation,
• KPL – module for planning and performing corneal transplant.

The laser, available in our clinic, increases the safety of the operation as a result of:

• greater, in comparison with other lasers, laser energy stability,
• more perfect photoablation than before (a sample of laser photoablation is based on fractals),
• more accurate connection of the set parameters with visual impairment,
• more accurate localization of laser pulses following the pupil and micromovements of the patient’s eyeball,
• high-precision computerized adjustment and calibration of laser beam centering.

The operation is contraindicated for the following persons:

under 21 years old and over 60 years old, pregnant or breastfeeding, patients who are prescribed steroid treatment, people with connective tissue diseases, patients with diabetes mellitus, with autoimmune diseases, with decreased immunity, allergy sufferers, people with active infections, with a pacemaker, those with progressive visual impairment, with high-grade degenerative myopia, with unopened cataract, with glaucoma, with retinal diseases, with keratoconus, with nystagmus, with dry eye syndrome, with vascular diseases of the eye

DESCRIPTION OF OPERATION

After eye anesthesia with drops, we put a metal dilator on the eye.The laser shoulder is positioned above the eye. We ask the patient to look at the luminous dot located on the laser’s shoulder. The operating time of the laser is several tens of seconds, during which the eye must be stationary. No pain is felt during the operation. We operate on both eyes at the same time.

AFTER OPERATION

After half an hour, the patient can go home. It is recommended to be accompanied by an adult. Within 3 hours after the operation, the patient may feel a burning sensation and watery eyes in the operated eye.You cannot squeeze the eyelid and rub the eye! 3 days after the operation, we conduct a follow-up examination of the patient (included in the cost of the operation).

For 3 weeks after the operation, smoke (including tobacco) and dust should be avoided. Do not wet your eyes while showering or in the pool. Do not use the sauna or solarium. It is recommended not to lift weights (over 15 kg). Avoid exposure to sunlight. It is recommended to wear sunglasses with UV filter.

FREQUENTLY ASKED QUESTIONS

What are the risks of laser vision correction?
Complications occur in less than 1% of cases.Most often these are postoperative infections.

What are the most common side effects of the procedure?
Vision problems after dusk. Blurred vision of light points. Weakening of contrast vision. Hypersensitivity to light. Halo around light sources. These consequences are rare and usually disappear 6-12 months after surgery.

Can the lack of vision reappear some time after the operation?
A few percent of patients return to vision impairment of about one diopter.This deficiency can be re-corrected one year after the operation.

If you want to know if you can perform laser vision correction, then make an appointment with a doctor in our clinic by phone (22) 664 44 33 or 693 722 448.

ATTENTION!

If you are planning to perform laser vision correction, remember that 4 weeks prior to the examination prior to refractive surgery, contact lenses should not be worn.

causes of development, symptoms, treatment methods

Among all eye diseases, eyelid chalazion in a child is common.Pathology is associated with a blockage of the sebaceous gland located at the edge of the eyelid. This condition is treated with conservative methods, but the best effect is given by surgery.

Essence of pathology

In the skin of both eyelids, there are several dozen small glands that produce sebaceous secretions. They are called meibomian. Sebum has a protective function, prevents drying out of the eyelids and ensures their sliding. Normally, the sebaceous secretion is produced and excreted from the ducts of the gland constantly.Fat maintains the right amount of tear fluid, preventing its excess or lack.

Under the influence of certain factors, the meibomian gland duct becomes clogged. The output of the produced fat stops. It accumulates inside the ducts, the gland stretches, acquires a spherical shape. This is how the chalazion of the eyelids develops in a child. The glands may become clogged in one or both eyelids. One-sided lesion of the upper eyelid is more often observed.

Chalazion of the eyelids in a child is a disease arising from stagnation of the sebaceous secretion in the meibomian gland

Causes of

Blockage of the meibomian gland results from:

• insufficient adherence to personal hygiene;
• Frequent mechanical irritation of the eyelids – when the child rubs his eyes with his hands;
• incorrect wearing of contact lenses;
• defects in the development of the ducts of the gland;
• low activity of the eye muscles.

Possible reasons for the formation of a chalazion include a decrease in immunity, myopia or farsightedness in a child.

Contamination of the eyelids leads to the penetration of bacterial flora into the gland. Then a purulent inflammatory process develops, complicating the course of the chalazion.

Symptoms

The manifestations of the disease are clearly visible. Their severity depends on the duration of the disease. The main signs of the chalazion of the century in a child include:

• swelling of the affected eyelid;
• a spherical seal is formed along the lash line;
• leather over the seal is taut, shiny.

The size of the chalazion depends on the amount of accumulated greasy secretion. Usually the tumor is no more than 5-7 mm in size, but it can grow up to several centimeters. Chalazion is not accompanied by painful sensations. The features of the upper chalazion are faster growth, transition to the inner side of the eyelid. This interferes with closing the eyes, the mucous membrane dries quickly. There are unpleasant sensations – itching or burning.

In the case of the lower chalazion, this situation rarely occurs.But here suppuration of the gland occurs more often due to the addition of bacterial flora. The eyelid swells more and the skin becomes red and hot to the touch. When pressure is applied to the tumor, pain occurs.

Chalazion is always limited to a capsule. It gives it a spherical shape and prevents the tumor from spreading to the surrounding tissues.

The general condition of the child rarely suffers. In newborns and infants, the temperature may rise to 37-37.5 degrees.This happens when a chalazion is infected. A complication of bacterial inflammation is the formation of a fistula. Pus breaks through the surface of the chalazion, a channel is formed between the bottom of the tumor and the environment.

In its manifestations, chalazion, especially infected, resembles barley. But there are significant differences between these diseases. The barley grows quickly, then softens and bursts. After all the pus is released, the barley disappears. Chalazion grows slowly, in the process of growth it becomes more and more dense.It rarely bursts on its own, and if this happens, the wound does not heal for a long time.

Symptoms of infected chalazion are similar to barley

Diagnostic methods

It is not difficult to diagnose chalazion. An external examination is sufficient for the doctor; additional examination methods are not required. If the tumor festers, the discharge from it is taken for analysis to determine the nature of the bacterial flora.

Treatment tactics

Treat chalazion conservatively or surgically.An ophthalmologist is doing this. Drug treatment can be used at an early stage of the disease or in the event of a tumor breakthrough. If conservative therapy is ineffective, the clogged sebaceous gland is excised.

Drug treatment includes application:

• antibacterial drops with tobramycin or ofloxacin;
• tetracycline ophthalmic ointment;
• drops with interferon.

Daily massage of the eyelids with a special eye stick is recommended.This helps to cleanse the sebum from the ducts. Chalazion dissolution occurs under the influence of physiotherapy – magnetotherapy, UHF.

If conservative therapy does not give the desired effect for 5-7 days, the doctor recommends surgery.

The operation consists in excision of the meibomian gland. It is performed under local anesthesia. Anesthetic is instilled into the lower eyelid. After 5-7 minutes, the sensitivity of the skin and mucous membranes is lost.The surgeon fixes the eyelid with a clip, makes an incision in the skin. Through the incision, he removes the gland covered with a capsule, rinses the wound with an antiseptic and sutures.

The eye is covered with a bandage for several days. The wound is treated with antibacterial ointment. The dressing is changed daily for 3-5 days. Surgical intervention is easily tolerated by the child, there are no complications. A more modern method of surgical intervention is the removal of the gland with a laser. The procedure takes only a few minutes, the postoperative period is significantly reduced.Less commonly, bleeding and infectious complications occur.

For children under two years of age, it is recommended to operate on the eye under anesthesia.

The use of folk remedies in the therapy of chalazion is not justified. Home remedies cannot clear a clogged sebaceous gland, nor do they dissolve swelling. You can use folk recipes as an additional therapy. Use those drugs that have anti-inflammatory and antiseptic effects:

• lotions with aloe juice;
• cabbage compress;
• rubbing with potato juice;
• tea compresses.

If the use of home prescriptions does not give a positive effect within 2-3 days, self-medication should be discontinued and a doctor should be consulted.

If the cause of the disease is the microbial flora, antibiotic drops are prescribed

Forecast

Chalazion is not a very dangerous disease if it is detected in time and treated. With the correct therapy, the tumor disappears completely, no traces remain.

If you do not pay attention to the growing chalazion, it reaches a large size. Complications occur:

• dry eye syndrome;
• eversion of the eyelids;
• astigmatism;
• decreased vision;
• conjunctivitis;
• eyelash loss.

The most dangerous is the suppuration of the meibomian gland. A bacterial infection from the eye area can spread into the cranial cavity.Meningitis or brain abscess develops. When a fistula forms, a rough scar remains on the eyelid, which deforms it. The child may develop squint.

Prevention of re-disease

Recurrence of chalazion is a rare situation. However, repeated cases of the disease are still possible and must be prevented. Preventive measures include:

• careful observance of personal hygiene;
• maintenance of immunity;
• proper nutrition;
• timely detection and elimination of other eye diseases.

The parents of the child should monitor the observance of hygiene, and also teach him to follow these rules on a daily basis. In the morning and in the evening, you need to wash your face, paying special attention to the eye area. If the baby has already had a chalazion, you need to regularly massage the eyelids to prevent the accumulation of sebum.

The rational nutrition of the child is important. To regulate the work of the sebaceous glands, the menu should include fresh fruits and vegetables, sea fish, nuts. It is useful to give the baby freshly squeezed juices, fruit drinks.Regular walks in the fresh air, swimming in the pool, and playing sports help to strengthen the immune system. In autumn and winter, it is recommended that the baby be given multivitamin complexes.

Such ophthalmic diseases as myopia or hyperopia, astigmatism, are risk factors for the formation of chalazion. If the baby has such pathologies, vision correction should be performed.

Chalazion does not cause significant discomfort to the child. But if the disease is not treated, the tumor becomes large.And this already leads to the development of complications, some of them are irreversible. The best way to get rid of chalazion is by surgical removal.

Video

See below: chronic tonsillitis in a child

Eyelid Surgery

Eyelid Surgery (Blepharoplasty) – is the process of removing excess fat, muscle and skin tissue from the lower and upper eyelids and tightening the area around the eyes that support these tissues.This surgery corrects sagging, twisted inward or outward upper and lower eyelids, bags formed due to the accumulation of excess fat, and wrinkles around the eyes.

WHAT IS THE DESCENT OF THE CENTURY?

Dropped eyelids , drooping upper eyelid called “Ptosis “. This eye problem is present from birth or develops later for various reasons and manifests itself as drooping of the eyelid covering the iris of the eye by more than a millimeter.Patients with drooping eyelids need to be treated not only for aesthetic discomfort, but also because it will cause problems such as narrowing of the visual fields. In children, drooping of the eyelids can cause a “lazy eye”. If lazy eye syndrome appears, then it is necessary to operate before the age of 6.

The disease is observed in people of any age, it can be congenital (congenital ptosis) or develop later.

Congenital Upper Eyelid Pathologies

Ptosis of the upper eyelid (Ptosis) is the most common congenital eyelid pathology.In addition, there may be diseases of the eyelids, such as adhesions of the eyelids (ankyloblepharon), eversion inward (entropion) or outward (ectropion) of the edge of the eyelid, incomplete formation of the eyelid (coloboma), an extra row of eyelashes (distichiasis).

WHAT ARE THE SYMPTOMS OF DESCENTED LIDES?

Dropped eyelids can often be caused by hereditary problems or muscle disorders.

Symptoms in patients with drooping eyelids may be as follows.

• Tries to lift the eyelids by raising the eyebrows
• Tired and drooping expression
• Dry eye or excessive lacrimation
• Narrowing of the field of view

WHAT ARE THE TREATMENT METHODS FOR LOWERED LIDES?

Treatment of ptosis is possible by surgery.Since this problem occurs at any age, treatments can vary according to age groups. As a rule, in children, surgical intervention is performed to prevent the development of vision problems and amblyopia, after which it is possible to recommend the use of special glasses with occlusive therapy and the use of eye drops. If the patient is an adult, you can remove the excess tissue on the eyelid that is visible from the outside and impair the vision, or act on the muscle holding the eyelid.

When surgery is required for drooping eyelids, treatment is carried out by our oculoplasty specialists.Treatment is surgery that takes about 20 minutes and is usually performed under local anesthesia.

What Are Congenital Upper Eyelid Defects?

Ptosis of the upper eyelid (Ptosis) is the most common congenital eyelid pathology. In addition, there may be diseases of the eyelids, such as adhesions of the eyelids (ankyloblepharon), eversion inward (entropion) or outward (ectropion) of the edge of the eyelid, incomplete formation of the eyelid (coloboma), an extra row of eyelashes (distichiasis).

What Are Age-Related Age Changes?

With age, drooping of the eyebrows and eyelids, eversion of the lower eyelid inward or outward, bags or depressions around the eyes and wrinkles occur.These complaints can also be caused by hereditary factors in young people. Changes in the eyelid show a person unhappy, tired and sleepy. The type of treatment is determined depending on the type of problem.

What are Ingrown Eyelashes? (Trichiasis, Distichiasis)

Ingrown eyelashes can occur congenitally (distichiasis) or after certain eyelid diseases, as a result of eversion of the eyelid margin inward (entropion) or eyelashes (trichiasis). They damage the transparent layer of the eye called the cornea.Treatment is surgical.

What is the Treatment for Congenital Eyelid Defects?

Ptosis of the upper eyelid (Ptosis) is the most common congenital eyelid pathology. In addition, there may be diseases of the eyelids, such as adhesions of the eyelids (ankyloblepharon), eversion inward (entropion) or outward (ectropion) of the edge of the eyelid, incomplete formation of the eyelid (coloboma), an extra row of eyelashes (distichiasis). The treatment for these diseases is surgery.

What is Inversion of the Eyelid Inside? (Entropion)

Entropion, which usually occurs in the lower eyelid, is formed when the eyelid is turned inward.Inversion of the edge of the eyelid inward can be congenital or develop later. Surgical treatment is used.

What is the Turn of the Century Outward? (Ectropion)

The outward turning of the eyelid margin usually occurs as a result of aging. It can also develop after congenital paralysis of the nerve covering the eyelid (facial nerve palsy) and injuries. Surgical treatment is used.

Is Treatment for Facial Nerve Paralysis Possible? (Facial paralysis)

Facial paralysis occurs when the nerve that moves the eyebrows, eyelids, and face fails for any reason.In the case of temporary paralysis, eye protection treatment is applied. For persistent paralysis, various surgical treatments are used.

How to Treat Eye Bags?

The main reason for the formation of bags under the eyes is genetics, that is, heredity. The second reason is thyroid disease. Bags under the eyes give the face an elderly and tired look. It is treated by removing excess fatty tissue or changing its location.

Operations can be performed under local anesthesia and their effect lasts for a long time.Lower eyelid surgery can often be done through the eyelid without the need to cut the skin. Thus, the problem of scarring or deformation of the eyelid after surgery is eliminated.

What is Eyebrow Lift Surgery?

Patients may have drooping eyebrows and excess skin on the eyelids. Typically, due to age or genetics, the lateral portions of the eyebrows can be pulled down by gravity. Such a fall creates a load on the eyelids, forms excess eyelid skin and spoils the aesthetic appearance.

With straight browpexy, the incision is made just above the eyebrows, parallel to the hairs on the eyebrows, and the eyebrow is raised. This incision can be made with a scalpel or carbon dioxide laser. The incision scar becomes invisible within 3-6 months, but may be visible for a while. Rarely used, with internal browpexy, an incision is made from the eyelid line, as in a technique we call blepharoplasty. Especially effective for lowering the outer 1/3 of the eyebrow. This is a method that does not leave marks on the eyebrows.

WHAT IS BLAPHARITIS (EYELASH ROOT INFLAMMATION)?

There is a gland duct under each eyelash. These glands secrete, nourish, and moisturize the frontmost transparent layer (cornea) of our eye. Thus, our vision becomes clear.

In some people, these glands are narrow. These glands, called the meibomian glands, become infected as a result of stenosis. This causes cracking at the base of the eyelashes, falling out of the eyelashes and frequent inflammation, it can even cause the formation of a cyst on the eyelids – HALASION.

Blepharitis is a chronic disease. The patient goes from doctor to doctor in search of a cure. Each doctor prescribes different drops or antibiotic cream, the patient thinks he will be cured. However, the main treatment is HOT LEAF and CLEANING THE EYELASH BASE EVERY MORNING. Some patients do eyelash cleaning at night due to lack of time in the morning. The main thing is to clean the BASES of the eyelashes daily.

Blepharitis is very common in patients with seborrheic disease and in patients with rosacea.

TREATMENT:

Eye Relax device. The patient buys this device and uses it at home. With this device, the eyelids are heated for 5-10 minutes every morning or evening and the meibomian glands are released. Thus, blepharitis goes away.

IPL (Intense Pulsed Light) procedure. This device is used to treat a patient in a hospital. The patient comes to the procedure with this device at intervals prescribed by the doctor (presumably once a week for 1 or 3 months).With this device, the disease is treated by supplying certain doses of energy to the meibomian gland and eyelids. It is also the method used for dry eye.

Hot bandage every day. Wash your eyelids frequently throughout the day with hot tap water. Applying hot water, for example in showers, saunas and spa treatments, relieves blepharitis. The more often you rinse your eyes throughout the day, the more comfortable you will feel. This practice can even be applied 20-30 times. If you like, you can also do this with a cotton pad or a cloth dampened in hot water.

Massage. After the hot compress, press the lower eyelid against the base of the lashes, releasing the contents of the glands. As the narrow ducts of the gland are dilated with hot water, the ducts of the glands are immediately emptied during the massage.

Shampoo. You will apply this shampoo on the base of your lashes at night and go to bed without rinsing. Before this procedure, you need to wash your eyelids with warm (as much as you can withstand) water, which softens the glands of the base of the eyelashes.

Cleaning with medicated wipes. Since dandruff and peeling appear at the base of the lashes, it is necessary to clean the base of the lashes after a hot compress and massage every morning and massage. Since the S. aureus microbe and the demodex parasites settle at the base of the eyelashes, cleaning with medicated wipes will quickly cure blepharitis. Healing wipes are much more effective than eye shampoos, and when used together, the effect is enhanced even more.

Antibiotic drops. If your doctor deems it necessary, he will prescribe drops to kill germs and parasites. Use these drops as directed by your doctor. This period is usually 7 days. Then stop taking the drug. Continue cleansing with warm compresses, massage and healing wipes.

Remember, blepharitis is a chronic disease. So it can happen again. Therefore, apply the above instructions within 3 months. When it repeats, follow the same steps. This is the way out of this situation.

Use of glasses. If you need glasses and do not wear them, blepharitis very often recurs and does not respond to treatment. In this case, it is better to use glasses or, if your eyes match, to correct the defect with an excimer laser.

Stress. Blepharitis and chalazion are very common in people who are under stress and “see the glass as half empty.”

Use of a pencil for women. Blepharitis and chalazion are common among women who use eyeliner because the base of the eyelashes is clogged with the pencil.If you have blepharitis or chalazion, we recommend that you completely eliminate eyeliner from your life. On the other hand, mascara should only be applied to the tips of the lashes, not to the base.

Briefly: APPLY THE SHAMPOO BEFORE BELT AT NIGHT AND CLEAN WITH MEDICINAL WIPES IN THE MORNING.

HALYAZION

In the absence of treatment, blepharitis and barley (hordeolum) become chalazion. If a chalazion has occurred, THERE IS NO OTHER TREATMENT EXCEPT OPERATING. Since the operation is performed from the inner surface of the eyelid, no stitches are applied and no scars remain.If the operation to remove the chalazion is postponed, it may infect the other eyelids and require an operation on all eyelids. If chalazion has developed, have the operation done within 1 month. If you do what is described in the treatment section above after the chalazion operation, you will prevent its re-formation.

What is Almond Eye Aesthetics?

Aesthetic operation of the almond eyes is aimed at slightly raising the eyes. These operations, which have recently begun to be carried out quite often and delight many women, give a more aesthetic appearance to the face and the area around the eyes.Thanks to the almond eye surgery, a completely new aesthetic appearance of the corners of the eyes is achieved, the areas where women apply makeup most and where deformities develop over time.

How Is Aesthetic Tonsil Surgery Performed?

Surgery for the aesthetics of the amygdala is performed under local and general anesthesia. Thanks to the anesthesia applied before the operation, there is no pain during the procedure. The operation takes about an hour or an hour and a half. It can also be performed in conjunction with surgeries such as upper and lower eyelid aesthetic surgeries and brow lift.There is usually no pain after surgery, but bruising or swelling may appear. The average duration of these edema is 5 to 7 days.

Ophthalmology department

Head of the department – Baygubakova Gulnara Sultanovna.

Salekhard, st. Mira, 39; 3rd floor.

Types of assistance provided by the department:

-Surgical interventions for (glaucoma, myopia, PHO and other operations on the organs of vision), as well as operations on the eyelids (chalazion), drainage of abscesses.

-Conservative treatment is provided to patients with diseases such as:

-Myopia;

– Glaucoma;

-Diseases of the retina;

– Inflammatory diseases of the eyes, eyelids (uveitis, iridocyclitis, keratitis, corneal erosion, herpetic eruptions of the eyelids, dacryocystitis, abscessing barley, phlegmon,

– Optic disc atrophy;

Employees of the ophthalmology department:

-I.o. head of the department, ophthalmologist – surgeon – G. BaygubakovaS.

-St. m / s – Boriskina E.V. – Category I;

– Chamber m / s – Groznykh K.G. – the highest category;

– Chamber m / s – Bondarenko V.P. – the highest category;

– Chamber m / s – Chubko L.N. – the highest category;

– Chamber m / s – Lopatina D.Yu. – Category I;

-m / s treatment room – Chupakova N.Ya. – the highest category;

-m / s diagnostic room – Tekutyeva L.I. – the highest category;

Contact information:

Tel.Branches 8 (34922) 4-48-86; 4-58-45; 4-58-77.

Memo to a patient with glaucoma.

Glaucoma is an eye disease characterized by increased pressure inside the eye, trophic disorders in the optic nerve, retina, leading to a decrease in visual acuity.

The correct lifestyle is of great importance for the successful treatment of glaucoma. First of all, it is necessary to regulate sleep. A patient with glaucoma should sleep at least 8 hours a day, while sleep should be calm and deep.It is not recommended to eat before going to bed, you should ventilate the room well, take a walk in the fresh air, sleep only on high pillows, since a low head position during sleep can cause an increase in intraocular pressure. In the morning after sleep, you need to immediately get out of bed, because in the morning hours intraocular pressure is highest, and wakefulness, movements and vertical position of the body contribute to its decrease. With insomnia, prolonged exposure to darkness can cause increased intraocular pressure.In these cases, it is advisable to take sleeping pills as directed by a doctor. You can watch TV only in a lighted room, while the light source should be behind your back. Glaucoma patients involved in photography are not recommended to develop and print photographs due to the need for a long stay in the dark.

It is not advisable to wear dark sunglasses, as thick smoky glasses create semi-darkness and can increase intraocular pressure.Special green glasses have a beneficial effect on intraocular pressure. For the same reason, it is recommended to use green lampshades on table lamps.

Moments causing flushing of the head should be avoided. Therefore, the work associated with bending the body (weeding the beds, washing and rubbing the floors, washing clothes, chopping wood, etc.), lifting weights and straining (working as a loader, playing wind instruments) is harmful. Light physical work is useful, as it helps to reduce intraocular pressure.Useful morning and evening leisurely walks in the fresh air, morning physical exercises, playing table tennis, cycling, rowing.

Reading, embroidery, drawing and other work at close range are not contraindicated in patients with glaucoma. It should be remembered that poor lighting and fatigue can cause the opposite phenomenon – an increase in intraocular pressure.

In the summer, on sunny days, you must not walk with your head uncovered or take sun baths.You can stay on the beach until 10 am and after 6 pm. Prolonged stay in the bath, especially washing the head with hot water in an inclined position, increases intraocular pressure. It is not recommended to stay near a hot stove for a long time, as well as to wear clothes with tight collars.

Patients are contraindicated to smoke tobacco, ingestion and injections of atropine, belladonna powders and caffeine. This should be borne in mind when referring to doctors of other specialties. They need to be informed about their illness.

Long food breaks are not recommended. You should eat at least four times a day, spreading the food intake evenly throughout the day. The last meal should be no later than two hours before bedtime. It is necessary to exclude from the diet foods and drinks that stimulate the nervous system: natural coffee, strong tea, smoked meats, fried meat, pickles. The use of alcoholic beverages is completely contraindicated. Meat can be eaten 3-4 times a week, boiled or baked.

Recommended list of foods and meals in the diet of patients with glaucoma.

• Wheat and rye bread.
• Vegetarian vegetable soups.
• Low-fat beef, veal, chicken, rabbit (boiled).
• Low-fat types of fish: pike, carp, pike perch, cod, navaga (boiled).
• A variety of vegetable dishes and side dishes.
• Dishes and side dishes, from cereals, pasta, noodles, noodles.
• Sweet dishes, fruits, berries in all kinds.
• Milk, kefir, yogurt, cottage cheese.
• Vegetable butter (limited ghee).
• Sauces with milk, vegetable broth, fruit.

Abundant fluid intake increases the intraocular pressure of patients with glaucoma, so they should limit fluid intake to 1.5 liters per day. Drinking more than one glass at a time is not recommended.

Daily bowel movement without significant straining is a prerequisite for a patient with glaucoma. Stool retention is the cause of chronic poisoning of the body by metabolic products from the intestines.If, despite adherence to the diet, the patient suffers from constipation, you should contact the appropriate specialist.

Important to remember!
It is necessary to strictly follow the regimen recommended by the doctor and not change it at your own discretion.

The prescribed treatment should be carried out systematically and without gaps, drops should be instilled at a strictly defined time.

Despite the fact that currently proposed new drugs that significantly reduce intraocular pressure, they do not exclude the need for surgical intervention in a number of patients with glaucoma.If active drug treatment does not sufficiently reduce intraocular pressure, then they resort to surgical intervention.

With a favorable course of glaucoma, subjective sensations do not bother the patient and it may seem that he is completely healthy. Despite this, you should visit your doctor once every 2-3 months. At the first unpleasant sensations (vision of “fog” or rainbow circles, slight pains in the eye or brow region, etc.), it is necessary, without waiting for the period appointed by the doctor, to contact him for an extraordinary examination.

When moving to another city or another area of ​​the city, you should take an extract from the medical history with information about your illness and treatment. At the new place of residence, it is necessary to go to the eye doctor with this statement and register with the dispensary.

Timely started and correctly carried out treatment, as well as strict adherence to the recommended regimen, allow you to preserve vision for many years.

Dear patient!

You have been implanted with an artificial lens of the eye, the scientific name of which is “intraocular lens” (IOL).In order for the artificial lens to serve you for a very long time, we ask you to show increased caution in the postoperative period and comply with the necessary medical requirements:

Do not engage in heavy physical work, do not make sudden movements, bends, jumps, do not run. You can carry a load of up to 3-5 kg ​​in your hands.

Limit the consumption of alcoholic beverages.

Sleep mainly on the back or on the side opposite to the operated eye.

If possible, avoid visiting the bathhouse for 3 months.

Limit the time spent in the hot tub.

When washing, be careful to avoid getting water into the operated eye.

Wear tinted glasses in strong light and on very bright sunny days.

Do not catch a cold.

Monitor your general condition with a local therapist (blood pressure, diabetes mellitus and other concomitant diseases), take measures to prevent constipation.

Special warning – about medications that dilate the pupil.They are contraindicated for the implantation of a pupillary lens model (LIOL-50 type). It is necessary to talk about this to all doctors who will prescribe any medications for you in the future.

In case you have a posterior chamber lens implanted (LIOL-10, LIOL-30 and others), the use of drugs that dilate the pupil is not contraindicated.

In 3 months after the operation, all restrictions can be gradually weakened, and then in many respects canceled.

You can pick up glasses 1 month after the operation, at the clinic at your place of residence.

Observe an ophthalmologist at the place of residence or at the OGD of your choice.

In case of a sudden decrease in visual acuity, inflammation of the eye, etc. You should urgently contact your optometrist at your place of residence or OGD.

We wish you good eyesight and all the joys in your life! 😉

Dear patient!

You underwent surgery. We ask you to show increased caution in the postoperative period and comply with the necessary medical requirements:

Do not engage in heavy physical work, do not make sudden movements, bends, jumps, do not run.You can carry a load of up to 3-5 kg ​​in your hands.

Limit the consumption of alcoholic beverages.

Sleep mainly on the back or on the side opposite to the operated eye.

If possible, avoid visiting the bathhouse for 3 months.

Limit the time spent in the hot tub.

When washing, be careful to avoid getting water into the operated eye.

Wear tinted glasses in strong light and on very bright sunny days.