Managing Chalazion in Special Needs Children: Concerns and Care Tips

Chalazion fibrosis

Dear Dr.
Wang,
My child is a special needs high school student with autism.
In August, we discovered that he had a chalazion on his left eye that was red and swollen.
Despite applying medication and taking oral medication, there was no improvement.
The doctor was concerned that my child might move around unpredictably, so he hesitated to perform the surgery in the clinic and suggested we go to a larger hospital for the procedure.
My child became very upset upon hearing this.
The doctor advised us to discuss with our child and return for a follow-up in September.
As parents, we are very worried; our child has limited understanding but also finds the daily application of medication uncomfortable.
Eventually, after some coaxing, the doctor applied a local anesthetic and quickly drained some of the pus.
The doctor informed us that, considering our child's special needs and fear of movement, it was not possible to fully drain the chalazion, which was not as swollen at that time.
In November, during the follow-up, the doctor mentioned that our child cannot tolerate the sensation of pressure like a typical person, and due to the fear of emotional distress and movement, the chalazion could not be completely addressed.
Currently, there is some fibrosis on the inner eyelid.
The doctor advised that we could bring him in for monthly check-ups and provided us with a topical ointment for use.
*Dr.
Wang: I am concerned about my child's unresolved chalazion, as a mother, I worry since it is related to the eye.
Currently, my child does not have any discomfort, but with some fibrosis present, will it improve over time?
*Will performing warm compresses on the eye help improve the fibrosis?
*Will the fibrosis affect the eye or the eyeball?
*The doctor said there is no need for medication; do you think my child should continue applying the medication? The ophthalmologist prescribed SULMEZOLE EYE DROPS and CHLORAMIN.

*Is it necessary to have monthly follow-ups?
*If there are any precautions we should be aware of, please let me know, as I am involved in special education promotion in my rural area, where medical resources are limited, and I have limited ability to ask questions.
I appreciate the medical team at Taiwan e-Hospital for helping clarify these medical concerns.
Thank you.
Dr.
Wang, I would appreciate your guidance on my worries, as my child has difficulty expressing himself, hears what is said, but lacks understanding.
Please help me; I am truly concerned.
If there are any important points to note, please let me know.
Thank you very much.

Tian Shi Kai Ma, 50~59 year old female. Ask Date: 2015/11/30

Dr. Wang Zhangji reply Ophthalmology

A chalazion can still be treated with medication and warm compresses, which may lead to improvement.
If it does not grow, observation is an option.
However, if it enlarges and exerts pressure on the eyeball, surgical drainage under general anesthesia may be necessary.

Reply Date: 2015/11/30

More Info

Managing a chalazion in children with special needs, such as autism, can be particularly challenging due to their unique behavioral and communication needs. A chalazion is a small bump on the eyelid caused by a blocked oil gland, which can become red, swollen, and uncomfortable. Here are some care tips and considerations for managing this condition in your child.

Understanding Chalazion
A chalazion typically develops when an oil gland in the eyelid becomes blocked. While it is not usually painful, it can cause discomfort and irritation. In your child's case, the presence of redness and swelling indicates that the chalazion may be inflamed.

Treatment Options
1. Warm Compresses: Applying a warm compress to the affected eye can help soften the hardened oil and promote drainage. This method is non-invasive and can be soothing for your child. You can do this several times a day for about 10-15 minutes. Ensure that the compress is not too hot to avoid burns.

2. Topical Medications: If your child has been prescribed eye drops or ointments, it is essential to follow the doctor's instructions. However, if the doctor has indicated that medication is not necessary at this time, you may not need to continue applying it unless symptoms worsen.

3. Surgical Intervention: If the chalazion does not improve with conservative measures, surgical drainage may be necessary. Given your child's special needs, it is crucial to discuss with the ophthalmologist the best approach to minimize anxiety and discomfort. Some children may require sedation for the procedure, especially if they have difficulty remaining still.

Behavioral Considerations
Children with autism may have heightened sensitivities and may react strongly to medical procedures. Here are some strategies to help manage your child's anxiety:
- Preparation: Explain the procedure in simple terms that your child can understand. Use visual aids or social stories to help them grasp what will happen. This can reduce fear of the unknown.

- Distraction Techniques: During appointments or treatments, use distraction methods such as toys, videos, or music to help keep your child calm.

- Routine: Establish a routine around eye care to create a sense of predictability. Children often feel more secure when they know what to expect.

Monitoring and Follow-Up
Regular follow-up appointments are essential to monitor the chalazion's progress. If your child is experiencing discomfort or if the chalazion is not improving, it is vital to return to the ophthalmologist for further evaluation. Monthly check-ups may be necessary, especially if the chalazion is not resolving.

Concerns About Fibrosis
You mentioned that there is some fibrosis present. Fibrosis can occur when the chalazion has been present for an extended period. While it may not directly affect vision, it can cause irritation or discomfort. Regular monitoring is essential, and warm compresses may help reduce the fibrotic tissue over time.

Conclusion
Managing a chalazion in a child with special needs requires a compassionate and patient approach. By utilizing warm compresses, following medical advice regarding medications, and preparing your child for any necessary procedures, you can help alleviate their discomfort and anxiety. Always maintain open communication with your healthcare provider and advocate for your child's needs, ensuring they receive the best possible care. If you have further concerns or questions, do not hesitate to reach out to your child's healthcare team for guidance.

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