Hailstone or chalazion is a benign eyelid tumor that forms due to blockage of a sebaceous gland in the eyelid and can swell up to the size of a hazelnut. The cause is usually an inflammation of the eyelid edges in the area of the meibomian glands (blepharitis).
As long as the hailstone hurts when touched, it is inflamed and should therefore be refrigerated. It usually encapsulates after a few days and is no longer sensitive to pain or reddening. Only at this point can an attempt be made to remove the mass in the chalazion from the affected gland by warming and careful massage. Sometimes this does not work and surgical removal is necessary.
The area around the affected eye is disinfected. The affected eyelid is then made insensitive using local anesthesia. With a fine lump, the eyelid is turned over (ectropiated).
The chalazion can now be opened with a precise cut perpendicular to the edge of the eyelid. This usually results in a whitish mass. There are often several hailstones, each of which is removed individually.
The remaining material is removed with a fine squeezing spoon. The remaining chalazion capsule is cut away with tweezers and micro scissors to reduce the risk of hailstone forming again in the same area.
Some ointment containing antibiotics and cortisone is placed in the conjunctival sac and the eye is bandaged with little pressure. This prevents more blood from escaping.
The bandage can be removed the following day.
It can happen that the incision to open the hailstone perforates the entire eyelid and eyelid skin. In this case, the skin defect can be sutured or closed again with a patch, so that the formation of a small visible scar cannot be prevented.
More rarely, there is a new hailstone in the same place.
In extremely rare cases, the edge of the eyelid or other anatomical structures can be injured during the procedure.
Physical exertion should be avoided on the day of surgery. For approximately two weeks, you should use Tobradex® eye ointment twice a day to prevent infections and reduce inflammatory stimuli.
The surgical area is anesthetized with lidocaine; you only feel the punctures of the local anesthetic. The operation itself is painless.
It is not uncommon for new hailstones to occur during surgery or elsewhere. Through regular Eyelid care (link) this risk can be significantly reduced.
The barley stone affects a different type of gland than the hailstone, is usually located directly on the edge of the eyelid and usually requires no operation as it empties more easily.
