By far the most common eyelid lump seen in a child is a "chalasion"or "meibomian cyst".

 They are very common in childhood, and seem to affect some children with recurrent cysts over years. They also tend to hang around if they don't settle within a couple of months.

Characteristics: not uncommonly start as an inflamed, tender lump, which may then discharge some purulent material, or otherwise just settle down to leave a firm round lump deep to the skin of the eyelid, either upper or lower. Pulling down the lower lid may reveal a red area or even small growth on the inside of the eyelid.


Good news: completely benign.

 

Bad news: Often they don't go away on their own, new cysts can come up elsewhere. Occasionally the cyst can affect the child's vision in one eye if it is quite large, pressing on the front of the eye, or very occasionally causing the upper lid to cover the pupil.

 

 
conditionsanddiseases_chalazion.gifThis diagram helps illustrate where the cysts originate: within the glands in the deep part of the eyelid. These glands are long tube-like structures that produce the oily part of our tears. They commonly become inflamed, and the oily secretions become thick and paste-like. These abnormal secretions are very irritating, and an inflammatory reaction begins in the tissue around them, the gland blocks off, and forms a cyst - a space filled with mucoid material and surrounded by inflammation, which is what makes it so large and frim. 

Treatment: Acutely inflamed cysts may be followed by redness and swelling that spreads throughou the eyelid. In children this must be treated promptly with oral antibiotics, or sometimes admission to hospital and medicine via a 'drip' if it becomes bad enough. Please see your family doctor immediately.

Most inflamed cysts settle within 1-2 weeks. Using a warm cloth for 5 minutes 2-3 times per day on the lid may help, but eyedrops are seldom useful. Persistent or large cysts may require a short surgical procedure (small cut through inside of eyelid, opening the cyst, so that the inflammatory material can be removed), which in children less than 14 will always require general anaesthesia.

Some children with recurrent or stubborn cysts may benefit from treatment with a 3-week course of an antibiotic, Erythromycin. This is to improve the function of the eyelid glands, hence preventing the formation of cysts.