Hypertrophic scar of the conjunctiva presenting as an eyelid mass: an unusual complication after surgical treatment of a chalazion
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Abstract:
To present a rare case of a conjunctival hypertrophic scar presenting as eyelid mass after surgical treatment of a chalazion. A 74-year-old man visited our clinic with severe ocular discomfort and excessive lacrimation since several months in his left eye accompanied by itching of the upper eyelid. Examination of the anterior segment revealed a 6 mm (horizontal) × 8 mm (vertical) round, immobile, hard, mushroom-shaped protruding mass on the tarsal conjunctiva of his left eye. There was no associated pigmentation, ulceration, or tenderness. Excisional biopsy of the benign conjunctival tumor was performed using radiofrequency electrosurgical systems. The region of the excised conjunctiva was well-healed on postoperative day 14, and there was no recurrence until 1 year post-surgery. Histopathological examination demonstrated thick interlacing collagenous fibrous bundles oriented in random directions and fibroblastic proliferation. Immunohistochemical staining revealed that spindle-shaped fibroblasts were positive for CD34 and negative for smooth muscle actin. The excessive collagenous tissue was stained blue by Masson trichrome stain. These findings were consistent with a hypertrophic scar of the conjunctiva. This short report demonstrates that a hypertrophic scar of the conjunctiva can develop after surgery of a chalazion and cause severe ocular discomfort and excessive lacrimation. These lesions can be easily removed using simple excision.Keywords:
Chalazion (fungus)
Hypertrophic scars
Meibomian gland
Itching
Dermatopathology
Background and Objectives
A chalazion, also known as a stye, is a common and chronic inflammatory problem of the eyelids where one or more Meibomian glands are blocked. Previous studies have shown that a chalazion is a sign of Meibomian Gland Dysfunction (MGD) and evaporative dry eye disease. The prevalence of chalazia in the pediatric population has recently been noted. In this report, we will describe two pediatric cases of chalazion that are associated with MGD and related dry eye disease.
Methods
This is a case report of non-genetically related 7-year-old and 16-year-old patients as they were each seen for newly developed chalazia.
Results
External exam in both patients showed chalazia, waxy plugs and poor Meibomian gland expression. Meibography showed shorten, truncated, and dilated Meibomian glands with rapid tear break-up times leading to the diagnosis of evaporative dry eye disease due to MGD.
Conclusion
These cases serve to confirm an increase in the prevalence of MGD in the pediatric population and to emphasize the need for early screening for dry eye disease.
Key Words: Chalazion - Meibomian gland dysfunction - Pediatric Dry Eye Disease
Chalazion (fungus)
Meibomian gland
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Abstract Background To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area. Methods This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution. Results At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients. Conclusions Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.
Chalazion (fungus)
Meibomian gland
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Abstract Background To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area. Methods This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution. Results At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74 ± 0.75, 0.48 ± 0.67, and 1.22 ± 0.60, respectively. One month after chalazion resolution, the parameters were 0.35 ± 0.49, 0.17 ± 0.49, and 0.91 ± 0.60, respectively; there was significant difference ( P < 0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference ( P > 0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93 ± 0.87, 1.07 ± 0.70, and 1.59 ± 0.76, respectively, and at 1 month after chalazion resolution, they were 0.93 ± 0.82, 0.95 ± 0.75, and 1.52 ± 0.70, respectively; there was no significant difference ( P > 0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference ( P > 0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients. Conclusions Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.
Chalazion (fungus)
Meibomian gland
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Abstract Background To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area. Methods This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution. Results At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients. Conclusions Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.
Chalazion (fungus)
Meibomian gland
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Meibomian gland carcinoma (MGC) is a rare but highly malignant slow growing tumor of the eyelid. MGC usually arises from meibomian gland located in the tarsal plate although rarely it can originates in the gland of zeis, sebaceous gland of caruncle, and periocular skin. MGC is more common in cases of elderly females. Upper eyelid is more commonly affected where the meibomian glands are more. Early diagnosis is very important but in most of the cases the diagnosis is delayed as it mimics chalazion or blepharo-conjunctivitis. This leads to inappropriate treatment and increase in morbidity and/or mortality. Special feature of this carcinoma is that it spread intra-epithelial and causes skipped lesions.
Meibomian gland
Chalazion (fungus)
Tarsus (eyelids)
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Meibomian gland
Chalazion (fungus)
Blepharitis
Grading (engineering)
Grading scale
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Abstract Background To observe the effects of chalazion and its treatments on the meibomian gland function and morphology in chalazion area. Methods This non-randomized, prospective observation clinical study included 58 patients (67 eyelids) cured of chalazion, including 23 patients (23 eyelids) treated with conservative method, and 35 patients (44 eyelids) with surgery. Slit lamp microscopy, infrared meibomian gland photography and in vivo laser scanning confocal microscopy (LSCM) were performed before treatment and 1 month after the chalazion complete resolution. The meibomian gland function, the area proportion and acinar structure in the chalazion area were analyzed before and 1 month after the chalazion resolution. Results In patients with conservative treatment, the meibomian gland function parameters improved at 1 month after chalazion resolution compared to those before treatment (P<0.05). There was no significant statistical difference in meibomian gland functional parameters before and after surgery (P>0.05). According to infrared meibomian gland photography, after chalazion resolution, the area presented meibomian gland loss, there was no significant statistical difference between the proportion of meibomian gland loss at 1 month after chalazion resolution and the proportion of the initial chalazion area (P>0.05) regardless of the treatment strategy. The acinar structure could not be observed clearly after the chalazion complete resolution. Conclusions Chalazion will cause meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method, but the range of the chalazion itself. Hot compress in conservative treatment can improve the meibomian gland function that chalazion located in short term.
Chalazion (fungus)
Meibomian gland
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Abstract Background: To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area. Methods: This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution. Results: At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients. Conclusions: Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.
Chalazion (fungus)
Meibomian gland
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Abstract Background To observe the effects of chalazion and its treatments on meibomian gland function and morphology in the chalazion area.Methods This nonrandomized, prospective observational clinical study included 58 patients (67 eyelids) who were cured of chalazion, including 23 patients (23 eyelids) treated with a conservative method and 35 patients (44 eyelids) treated with surgery. Infrared meibomian gland photography combined with image analysis by ImageJ software was used to measure the chalazion area proportion. Slit-lamp microscopy was employed to evaluate meibomian gland function, and a confocal microscope was used to observe meibomian gland acinar morphology before treatment and 1 month after complete chalazion resolution.Results At 1 month after chalazion resolution, the original chalazion area showed meibomian gland loss according to infrared meibomian gland photography in both groups. In patients who received conservative treatment, the meibomian gland function parameters before treatment were 0.74±0.75, 0.48±0.67, and 1.22±0.60, respectively. One month after chalazion resolution, the parameters were 0.35±0.49, 0.17±0.49, and 0.91±0.60, respectively; there was significant difference (P<0.05). The proportion of the chalazion area before treatment was 14.90 (11.03, 25.3), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.64 (10.33, 25.77); there was no significant difference (P>0.05). In patients who underwent surgery, the meibomian gland function parameters before surgery were 0.93±0.87, 1.07±0.70, and 1.59±0.76, respectively, and at 1 month after chalazion resolution, they were 0.93±0.82, 0.95±0.75, and 1.52±0.70, respectively; there was no significant difference (P>0.05). The proportion of the chalazion area before surgery was 14.90 (12.04, 21.6), and the proportion of meibomian gland loss at 1 month after chalazion resolution was 14.84 (11.31, 21.81); there was no significant difference (P>0.05). The acinar structure could not be observed clearly in the meibomian gland loss area in most patients.Conclusions Chalazion causes meibomian gland loss, and the range of meibomian gland loss is not related to the treatment method but to the range of chalazion itself. A hot compress as part of conservative treatment can improve meibomian gland function at the site of chalazion in the short term.
Chalazion (fungus)
Meibomian gland
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