Persistent Bump After Chalazion Surgery: What You Need to Know

Q: Persistent Bump After Chalazion Surgery: What You Need to Know

Hello Ms. <br>Pan： Please follow the treatment prescribed by your physician, and return for follow-up as advised. <br>If, after a period of treatment, the issue is still not resolved, your physician may suggest whether further surgery is necessary.

There is still a hard lump after the chalazion surgery?

Hello Doctor, on January 20th, I discovered a chalazion (a raised hard lump that is not painful when pressed) on the inner eyelid of my right eye.
I visited a nearby ophthalmology clinic on January 21st, where the doctor prescribed Tobradex eye drops and Betamethasone ointment, advising me to use the medication for five days and return for surgery if there was no reduction in size.
By January 26th, there was still no change, so I underwent chalazion excision surgery that day.
Postoperatively, I continued using Systane eye drops and Betamethasone ointment, along with a three-day course of oral antibiotics and anti-inflammatory medication.
As of February 8th (13 days post-surgery), I can still feel a raised hard lump on my right eyelid, although it has decreased in size compared to the initial presentation.
I had a follow-up appointment on January 5th, where I asked the doctor if this lump could resolve.
The doctor only mentioned that it might be granulation tissue and advised me not to worry too much, prescribing Systane eye drops and Bepotastine ointment for one month.
Normally, after chalazion surgery, there shouldn't be a raised hard lump remaining.
Could it be that my right eye's chalazion was not completely drained? Most importantly, is it possible for it to resolve on its own, or will I need another surgery to remove it completely? Thank you for your response, as I am really concerned about this.
QwQ

Miss Pan, 20~29 year old female. Ask Date: 2022/02/08

Dr. Gao Pilin reply Ophthalmology

Hello Ms.
Pan: Please follow the treatment prescribed by your physician, and return for follow-up as advised.
If, after a period of treatment, the issue is still not resolved, your physician may suggest whether further surgery is necessary.

Reply Date: 2022/02/08

More Info

After undergoing chalazion surgery, it is not uncommon for patients to experience a persistent bump or lump at the surgical site. This can be concerning, especially when the bump does not seem to diminish significantly over time. Here’s what you need to know about this situation.

Understanding Chalazion and Post-Surgical Expectations
A chalazion is a cyst that forms due to the blockage of an oil gland in the eyelid, leading to inflammation and swelling. Surgical removal is often recommended when conservative treatments, such as topical medications, fail to resolve the issue. After surgery, it is typical for some swelling and tenderness to persist for a few weeks as the area heals. However, if a hard bump remains after several weeks, it may indicate one of several possibilities.

Possible Reasons for Persistent Bump
1. Granulation Tissue: As your doctor mentioned, the persistent bump could be granulation tissue. This is a normal part of the healing process where new tissue forms as the body repairs itself. Granulation tissue can feel firm and may take time to resolve.

2. Incomplete Removal: In some cases, the chalazion may not have been completely excised during surgery, leading to residual tissue that can feel like a lump. If this is the case, it may require a follow-up procedure to ensure complete removal.

3. Scar Tissue Formation: Post-surgical healing can also lead to scar tissue formation, which may present as a firm bump. This is generally harmless and may diminish over time.

4. Infection or Inflammation: Although less common, an infection or persistent inflammation can lead to a lump. Signs of infection may include increased redness, warmth, or discharge from the surgical site.

What to Do Next
Given that you are now 13 days post-surgery and still feel a firm bump, it is advisable to follow up with your ophthalmologist. Here are some steps you can take:
- Follow-Up Appointment: Schedule a follow-up appointment with your eye doctor to evaluate the bump. They may perform a physical examination and possibly imaging studies to assess the area.

- Discuss Treatment Options: If the bump is determined to be granulation tissue, your doctor may recommend continued observation, topical treatments, or even a corticosteroid injection to reduce inflammation. If it is determined that the chalazion was not completely removed, a minor surgical procedure may be necessary.

- Monitor Symptoms: Keep an eye on any changes in the bump. If you notice increased pain, redness, or discharge, contact your doctor immediately, as these could be signs of infection.

Conclusion
While it is understandable to be concerned about a persistent bump after chalazion surgery, it is essential to communicate openly with your healthcare provider. They can provide a thorough evaluation and determine the best course of action based on your specific situation. Remember that healing can take time, and many patients experience varying degrees of swelling and firmness post-surgery. With appropriate follow-up care, you can achieve the best possible outcome for your eyelid health.

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