The hailstone (chalazion) is a chronic inflammation of sebaceous glands on the eyelid margin. Slow swelling of the sebaceous glands produces a rough, easily displaceable lump on the upper or lower eyelid. Unlike the barley grain (hordeolum), the signs of inflammation in the hail-grain are only slight and pain is missing. Only a feeling of pressure is palpable. Find out more about the hailstone here.
The hailstone occurs when the ducts of a sebaceous gland clog at the edge of the eye. Bacteria and the body’s own enzymes reduce fat components in the ducts. These degradation products enter the surrounding tissue and trigger a slow, chronic inflammatory response. This lures immune cells into the eyelid, forming a hard knot over several weeks. Since no infection with bacteria is responsible for the immune reaction, but the body’s own degradation products behind it, the hailstone causes no pain. It can, however, be unpleasant to the eye. Ultimately, however, it is mostly aesthetic reasons why sufferers go to the doctor to get a hailstones treatment.
A hailstone manifests as a slippable lump on an eyelid that grows slowly over several days to weeks, but does not heal or redden. However, the conjunctiva may be slightly red on the inside of the eyelid. Other symptoms such as fever do not occur. In addition, only the eyelid skin is affected by the hailstone. Eye itself and surrounding structures do not swell.
A chalazion is usually alone; Several hailstones in one eye are rare. In some cases, a chalazion is subsequently infected by bacteria. This is then no longer distinguishable from the painful barley grain, which is often red and very sensitive to touch.
Hailstone: Causes and Risk Factors:
The secretion accumulation on the lid, which underlies the hailstone, can occur spontaneously, but also due to many other factors. For example, similar to acne, the sex hormones also affect sebum production in hailstones. Since their full effect on sebum production comes after puberty, adult people develop chalazion more often than children. Other inflammations on the eye such as conjunctivitis and the skin disease rosacea (copper rose) may also favor chalazion. In general, all factors that hinder sebum flow increase the risk of hailstones.
For recurring sebaceous glands on the eye of the doctor should exclude some rare causes. These include diabetes (diabetes mellitus) and immunodeficiency. In very rare cases, a lid tumor can obstruct the septum flow and cause a hailstone.
Hailstone: examinations and diagnosis
The complaints that the patient describes, and the examination of the swelling on the edge of the lid are usually enough for the doctor to make the diagnosis “hailstone”. Some patients also suffer from multiple chalazions several times in their lives and therefore often know before they go to the doctor that they have hailstones on their eyes again. During the examination, the doctor looks for signs of complications. As a rule, a hailstone is not an emergency, and there are no dangerous consequences.
Unlike a bacterial infection, treatment with a hailstone takes longer. As a rule, one first tries to repair the secretion jam with dry, warm compresses and regular eyelid massages. Also, eye rinses are sometimes used on a hailstone. Home remedies (such as lukewarm eye baths and pads with various herbs) as well as homeopathic treatment options can aid the healing process.
Usually, these conservative therapies suffice that the chalazion regresses by itself within several weeks. If not, a surgeon can remove the hailstone. He opens the chalcone via a small skin incision and removes the inflamed tissue. Factors that speak for such a chalazion op are:
- feeling of pressure
- external disturbing findings
- Influencing the visual function
- Suspected malignant degeneration
The Hailstone Op is performed under local anesthesia and involves little risk. It is important that the chalazion is completely cleared, otherwise it can form again.
Hailstone: Disease course and prognosis
A hailstone is often found by patients to be very disturbing, especially for cosmetic reasons. It develops slowly over several weeks, and also the healing usually takes a long time. Overall, the forecast for hailstones is very good.
In rare cases, the hailstone may affect the eye and may limit vision. This is most likely to be the case with children and then requires rapid treatment. Because the visual function is very important for the learning process and the development of the brain in small children. If an eye is not involved in the visual process for several days or weeks due to a hailstone, there is a risk of long-term visual impairment. In adults, this is not the case, so that the course in adults is usually benign.
In rare cases, that can hailstone Signs of another disease, such as when someone receives more hailstones despite consistent therapy. Then, among other things, a (malignant) tumor as the cause must be excluded.