Despite the fact that chalazion is a disease mainly of age, characteristic of people aged 35 and older, sometimes it is diagnosed in children. And in this case, the question arises where the ugly formations on the inner eyelid come from and what to do with them. Both Dr. Evgeny Komarovsky and his wife, the pediatric ophthalmologist Ekaterina Komarovskaya, have to answer this question.
In this article, we have collected the most detailed answers to parenting questions about a child's chalazion.
What it is?
The name of this pathology is not found as often as rhinitis or bronchitis, and therefore most parents have no idea what they are talking about when they hear the word "chalazion". And we are talking about the formation of nodules on the inside of the upper or lower eyelid, small formations, which at first parents take for barley.
Barley is a purulent inflammation, it always proceeds only in an acute form. Chalazion is always a chronic disease. What happens in the child's eye? The eyelid becomes inflamed around the meibomian gland only if it clogs up and the secretion it produces accumulates in it.
Glands with such a complex name are located in the very thickness of the cartilaginous tissue, and their exits just fall on the inner part of the eyelid. In each eyelid (lower, upper, on the right and left eyes) there are up to 70 meibomian glands. They are responsible for the secretion of the lipid layer of the tear film.
If the lacrimal glands produce tears to moisturize the eyeball, the mission of the meibomian glands is to produce lipids to prevent rapid evaporation of the tear fluid.
If one of the glands becomes clogged, a lipid "hail" is formed, which is called "chalazion". The problem is widespread in people over 35 years old, elderly people. It is not so common in pediatric ophthalmology.
Causes of occurrence
No doctor will be able to accurately answer the question of why a child has a chalazion on the eye, since the reasons leading to the blockage of the meibomian glands are not known to the end of modern medicine. And therefore the main reason is officially considered to be the blockage itself.
Inflammation around the clogged gland and the lipid filling of its duct itself is a neoplasm that belongs to the category of benign.
What can lead to a blockage is a difficult question. Some experts believe that The "trigger" is the previous barley, especially if they were not completely cured... Also, factors accompanying the development of pathology considered oily skin, the presence of diabetes mellitus, blepharitis.
Scientists have even managed to find a connection between the occurrence of chalazion and diseases of the gastrointestinal tract and intestinal dysbiosis.
It is also believed that the appearance of ugly nodules on the inner eyelid contribute to stress, anxiety, past viral infections, lack of vitamins in the dietas well as improper use of contact lenses.
How to recognize?
Parents easily recognize this pathology, because it manifests itself quite characteristically - a rounded dense neoplasm appears on the inside of the eyelid. It differs from barley in that touching the "hailstone" does not cause pain, there is no pain when blinking.
The child's vision does not suffer from the presence of a chalazion. As the formation grows (and it can increase to 4-6 mm), the defect becomes noticeable when looking at the face without turning the eyelids. The skin begins to swell, which also does not affect the function of the organs of vision. If there are any inconveniences, then they are purely cosmetic.
Chalazion rarely interferes - there are cases when "hailstones" were the cause of increased tearfulness of the eye, and also itched. But this does not mean that you can leave a benign education alone with a clear conscience.
If nothing is done, the chalazion can continue to grow, and then the pressure on the cornea can cause astigmatism. If the chalazion exists for a long time and does not open, it can become a cyst.
Also, the "hailstone" can become infected with bacteria, and then there will be signs of purulent inflammation: pain, swelling, possibly even an increase in body temperature.
What should parents do?
First of all, Evgeny Komarovsky and his wife Ekaterina advise to calm down and not panic. If you have any doubts - barley or still chalazion, do not hesitate, you should contact a pediatric ophthalmologist. This specialist will immediately find all the differences and after a routine visual examination will be able to say with confidence what happened to the child.
You should not be afraid to go to an appointment. Chalazion most often does not require any other diagnostics other than visual: Instrumental techniques that may frighten or uncomfortable for the child are usually not used.
However, if chalazions begin to appear with enviable regularity, then the doctor may need to conduct a detailed study to distinguish chalazion from dangerous meibomian adenocarcinoma.
For this, a histological examination of the contents of the formation is prescribed.
How to treat?
To begin with, the ophthalmologist may recommend that parents wait a little, because in childhood cases of self-healing are quite frequent - the chalazion passes without a trace on its own.
If your parents can't sit back, an ophthalmologist may advise to instill disinfectant eye drops, lay an anti-inflammatory ointment... Also, mothers can massage the eyelids of the child. In a polyclinic the child can attend a course of physiotherapy - UHF therapy, eg.
Ekaterina Komarovskaya, an ophthalmologist specializing in children's eye health, claims that dry heating has an excellent effect... A diaper warmed up with an iron can be applied to the affected eyelid for five minutes, three times or four times a day. But this method is definitely dangerous for children with signs of an inflammatory process in the eye.
If the eye hurts, the chalazion itself is inflamed, heating will only contribute to the spread of inflammation.
If the chalazion is long and progressive (growing), lasts for more than six months, in the conditions of a medical institution, it may be recommended to inject cortecosteroid hormones with a thin needle directly into the chalazion itself. It dissolves from the action of hormones.
There are also surgical methods, in which, under local anesthesia, the ducts of the meibomian gland are cleaned by the surgeon, the "granule" of the chalazion is removed entirely, along with the surrounding inflammatory "capsule".
After surgical treatment, a tight bandage is applied to the child's eye. Recommendations are also given on the use of anti-inflammatory ophthalmic ointments and drops.
You should not be afraid of the wording "surgical excision". Medicine is able to offer young patients not only the traditional surgeon's scalpel. Today, operations are performed to remove the chalazion with a laser.
In this operation, the contents of the "hail" are removed without incisions - using a laser beam. It is a less traumatic procedure with an easier and easier recovery period, since no stitches are applied to the inner eyelid during laser surgery.
The main advantage of laser surgery for chalazion is the absence of the likelihood of relapse. After a normal operation, the likelihood that the lipid formation on the inner eyelid will appear again and more than one, exists.
But before parents start to think about the benefits of one type or another removing the chalazion, Ekaterina Komarovskaya and Evgeny Komarovsky recommend taking the following measures:
- apply dry heat for five minutes three times a day;
- twice a day to clean the edge of the eyelids from the rather fatty lipid secretion of the meibomian gland and dirt - for this, use a solution of baby shampoo ("no tears", of course).
If after six months the chalazion has not passed or it grows and increases in size, the parents should return to the ophthalmologist and this time to discuss more serious methods of getting rid of a baby from an ugly benign education.
The forecasts are very favorable. Most often, in children, education resolves on its own without the help of doctors and parents.... In other cases, the pathology responds well to treatment.
If the chalazion capsule was not completely removed, then it is possible that there will be a relapse. Cases of complications - the formation of an abscess at the site of a chalazion, phlegmon, as well as cysts or fistulas - occur no more often than in one in ten people with such a diagnosis. And this one in ten, as a rule, belongs to the category of children whose parents tried to remove the "hail" on their own (there are, alas, those who believe that the best treatment is to squeeze out, pierce and generously lubricate with antibiotic ointment).
It is strictly forbidden to touch the lipid neoplasm on your own, to try to remove it mechanically.
Prevention
Since the true causes of chalazion remain unknown, it is also not possible to develop specific preventive recommendations. Therefore, parents should pay attention to the child's compliance with general recommendations for the health of the organs of vision.
Since the meibomian gland can become clogged with dirt, it is important to teach your toddler never to rub his eyes with dirty hands, especially outdoors and in the sandpit.
Timely and correctly you need to treat such common childhood ailments as barley, conjunctivitis, blepharitis. If your child wears contact lenses, explain to him the hygiene rules, which he strongly recommends to take off and put on them with extremely clean hands, and store in a special solution.
And, of course, everything must be done to strengthen the child's immunity. With strong immunity, the child is not afraid of inflammation around the meibomian gland, the body can easily cope with it, and even if a blockage occurs, it will quickly heal itself and go away without a trace and the need for treatment.
In the next video, Komarovsky talks about other possible eye problems.
