Risk Factors for Chalazion Diagnosis and Subsequent Surgical Excision.

PURPOSE: To identify factors associated with chalazion diagnosis and surgical excision. METHODS: Patients with an incident chalazion diagnosis from 2002 to 2019 were compared 1:5 with matched controls. Multivariable logistic regression was performed to identify variables associated with diagnosis and surgical excision. RESULTS: Chalazion patients (n = 134,959) and controls (678,160) were analyzed. Risk factors for diagnosis included female sex, non-white race, northeast location, conditions affecting periocular skin and tear film (blepharitis, meibomian gland dysfunction, rosacea, pterygium), non-ocular inflammatory conditions (gastritis, inflammatory bowel disease, sarcoidosis, seborrheic dermatitis, Graves' disease), and smoking (p < .001 for all comparisons). Thirteen percent of patients with chalazion underwent subsequent surgical excision. Diabetes and systemic sclerosis diagnoses decreased odds of diagnosis (p < .001). Male sex, rosacea diagnosis, Black and Hispanic race, antibiotic use, and doxycycline use increased odds of surgery (p < .001). CONCLUSION: Female sex, non-white race, conditions affecting periocular skin and the tear film, several non-ocular inflammatory conditions, and smoking were risk factors for chalazion diagnosis. Male sex, rosacea diagnosis, Black and Hispanic race, antibiotic use, and doxycycline use were risk factors for surgical intervention for chalazion. Our results prompt further study of these variables and their relationship to chalazion diagnosis to understand physiology and improve clinical outcomes. Furthermore, the results of this study suggest early recognition and treatment of concomitant rosacea may serve an important role in the management of chalazion and in the prevention of surgical intervention.

Prevalence of Demodex folliculorum and Demodex brevis in patients with blepharitis and chalazion.

PURPOSE: Demodex folliculorum and Demodex brevis are common ectoparasites on skin that also can lead to blepharitis and chalazion. The aim of our study is to determine the prevalence of Demodex spp. in eyelashes of patients diagnosed with chronic blepharitis and chalazion. METHODS: This study included 330 patients diagnosed with chronic blepharitis, 70 patients diagnosed with chalazion and 130 volunteers without any ocular problems. Patient eyelashes were examined under a light microscope at magnifications of × 40, × 100 and × 400. Demodex spp. were determined. RESULTS: Parasite prevalence was significantly higher in blepharitis (75.5%) and chalazion groups (70%) compared to the control group (16.2%) (p < 0.001). The prevalence of D. folliculorum in the blepharitis group and D. brevis in the chalazion group was found to be significantly higher compared to other groups (p < 0.05). The average number of mites per eyelash was found to be significantly higher in patients with Demodex positive blepharitis (p = 0.001) and in chalazion patients (p = 0.047) than in the control group. It has been determined that mite positivity increases with age in blepharitis and control groups (p < 0.05). In the group with blepharitis, it was found that mite positivity was significant in the presence of symptoms (p = 0.0001) and Demodex positivity decreased as the education level of individuals increased (p = 0.039). CONCLUSION: The results of the study show that Demodex spp infestations should be considered in chronic blepharitis and chalazion.

Multivariate analysis of the effect of Chalazia on astigmatism in children.

BACKGROUND: Chalazion may affect visual acuity. This study aimed to evaluate refractive status of chalazia and effect of different sites, sizes, and numbers of chalazion on astigmatism. METHODS: Three hundred ninety-eight patients aged 0.5-6 years were divided into the chalazion group (491 eyes) and the control group (305 eyes). Chalazia were classified according to the site, size, and number. Refractive status was analyzed through the comparison of incidence, type, mean value and vector analysis. RESULTS: The incidence, type, refractive mean and of astigmatism in the chalazion group were higher than those in the control group, and the difference was statistically significant (P < 0.05). For comparison of the incidence, the middle-upper eyelid (50%) was highest, followed by 41.77% in the medial-upper eyelid, both higher than that in the control group (P < 0.05). In medium (54.55%) and large groups (54.76%) were higher than that in the control group (27.21%) (P < 0.05). In multiple chalazia, the astigmatism incidence for chalazion with two masses was highest (56%), much higher than that in the control group (P < 0.05). However, this difference was not significant in chalazion with ≥3 masses (P > 0.05). For comparison of the refractive mean,the medial-upper eyelid, middle-upper eyelid and medial-lower eyelid were higher than the control group (P < 0.05) (P < 0.05). The 3-5 mm and >5 mm group were higher than those in the control group and <3 mm group(P < 0.05), and the>5 mm group was larger than the 3-5 mm group，suggesting that the risk of astigmatism was higher when the size of masses > 5 mm. Astigmatism vector analysis can intuitively show the differences between groups, the results are the same as refractive astigmatism. CONCLUSION: Chalazia in children can easily lead to astigmatism, especially AR and OBL. Chalazia in the middle-upper eyelid, size ≥3 mm, and multiple chalazia (especially two masses) are risk factors of astigmatism. Invasive treatment should be performed promptly if conservative treatment cannot avoid further harm to the visual acuity due to astigmatism.

The association of demodex infestation with pediatric chalazia.

PURPOSE: This study aimed to investigate the association of Demodex infestation with pediatric chalazia. METHODS: In a prospective study, 446 children with chalazia and 50 children with non-inflammatory eye disease (controls) who underwent surgical treatment were enrolled from December 2018 to December 2019. Patient ages ranged from 7 months to 13 years old. All patients underwent eyelash sampling for light microscope examination, and statistical correlation analysis between Demodex infestation and chalazia, including the occurrence, recurrence, and course of disease, morphological characteristics, and meibomian gland dysfunction (MGD) in chalazia patients was performed. RESULTS: Demodex was found in 236 (52.91%) patients with chalazia and zero control patients. Demodicosis was significantly more prevalent in chalazia patients than the control group (P < 1 × 10- 14). Recurrent chalazia (P = 0.006) and skin surface involvement (P = 0.029) were highly correlated with Demodex infestation. Demodicosis was also associated with multiple chalazia (P = .023) and MGD(P = .024). However, Demodex infestation was comparable in the course of disease (P = 0.15), seasonal change (P = 0.68) and blepharitis subgroups (P = 0.15). Within the group of chalazia patients who underwent surgical removal of cysts, 4 (0.9%) patients with concurrent demodicosis experienced recurrence. CONCLUSIONS: Demodex infestation was more prevalent in pediatric chalazia patients than healthy children, and was associated with recurrent and multiple chalazia. Demodicosis should be considered as a risk factor of chalazia. In children with chalazia, Demodex examination and comprehensive treatment of Demodex mites should be applied to potentially prevent recurrence.

Chalazion: racial risk factors for formation, recurrence, and surgical intervention.

OBJECTIVE: An association between race and formation of chalazion has yet to be objectively established. This study investigates race as a risk factor for chalazion and chalazion surgery. Understanding racial risk factors in formation of chalazion, recurrent chalazion, and chalazion requiring surgery (often with general anesthesia in children) informs decisions regarding eyelid hygiene, early topical medical therapy, and aggressiveness with oral antibiotic therapy for coexisting conditions such as blepharitis. METHODS: Demographic data was collected for all pediatric visits to the University of Wisconsin-Madison ophthalmology department from 2012-2019. Retrospective chart review was performed for the subset with chalazion. RESULTS: Of 28 433 minors, 584 had 1088 chalazia, a 2% overall rate. Chalazion was seen in 1.8% of non-Hispanic/Latino participants and 3.8% of Hispanic/Latino participants (p value <0.0001). Chalazion was seen in 1.7% of white participants, compared to 4.3% of American Indian or Alaska Native participants (p value <0.0001) and 4.0% of Asian participants (p value <0.0001). More than one chalazion was recorded in 31% of subjects without coexisting meibomian gland disease, blepharitis, or marginal keratitis, and in 56% (p < 0.0001) with one of these conditions. Repeated diagnoses of chalazion on separate encounters were seen in 17% without these conditions and in 33% (p < 0.0001) with one of these conditions. CONCLUSION: Hispanic/Latino, American Indian, and Asian participants developed chalazion at a rate higher than other racial/ethnic groups, whereas patients with meibomian gland disease or blepharitis are especially at risk for developing multiple chalazia on separate encounters. No group was more likely to require surgical intervention than any other.

Prevalence and risk factors for chalazion in an older veteran population.

BACKGROUND: Chalazia are common inflammatory eyelid lesions, but their epidemiology remains understudied. This retrospective case-control study examined the prevalence, risk factors and geographic distribution of chalazia in a large veteran population. METHODS: Data on all individuals seen at a Veterans Affairs (VA) clinic between October 2010 and October 2015 were extracted from the VA health database. Subjects were grouped based on International Classification of Diseases, Ninth Revision (ICD-9) code for chalazion. Univariable logistic regression modelling was used to identify clinical and demographic factors associated with chalazion presence, followed by multivariable modelling to examine which factors predicted risk concomitantly. All cases were mapped across the continental US using geographic information systems modelling to examine how prevalence rates varied geographically. RESULTS: Overall, 208 720 of 3 453 944 (6.04%) subjects were diagnosed with chalazion during the study period. Prevalence was highest in coastal regions. The mean age of the population was 69.32±13.9 years and most patients were male (93.47%), white (77.13%) and non-Hispanic (93.72%). Factors associated with chalazion risk included smoking (OR=1.12, p<0.0005), conditions of the tear film (blepharitis (OR=4.84, p<0.0005), conjunctivitis (OR=2.78, p<0.0005), dry eye (OR=3.0, p<0.0005)), conditions affecting periocular skin (eyelid dermatitis (OR=2.95, p<0.0005), rosacea (OR=2.50, p<0.0005)), allergic conditions (history of allergies (OR=1.56, p<0.0005)) and systemic disorders (gastritis (OR=1.54, p<0.0005), irritable bowel syndrome (OR=1.45, p<0.0005), depression (OR=1.35, p<0.0005), anxiety (OR=1.31, p<0.0005)). These factors remained associated with chalazion risk when examined concomitantly. CONCLUSION: Periocular skin, eyelid margin and tear film abnormalities were most strongly associated with risk for chalazion. The impact of environmental conditions on risk for chalazion represents an area in need of further study.

Calázio e características demográficas dos portadores em uma amostra populacional / Chalazion and demographic characteristics of patients in a population sample

Objetivo: Apresentar a frequência de ocorrência do calázio em uma amostra populacional, assim como as características de seus portadores. Métodos: Estudo transversal utilizando amostra populacional aleatorizada, realizado nos anos 2004/2005, na região centro-oeste do estado de São Paulo. Os participantes foram avaliados segundo variáveis demográficas e exame oftalmológico. Resultados: A frequência de ocorrência do calázio foi de 1,56%, sendo mais frequente em mulheres, portadores de astigmatismo ou hipermetropia de pequenos graus, com grande variação de idade de acometimento. Foi necessária prescrição de correção óptica e cirurgia em número expressivo de casos. Conclusão: O calázio tem baixa frequência de ocorrência na população geral. Ocorre predominantemente em mulheres e há associação importante com ametropia.

Purpose: To show the frequency of occurrence of chalazion in a population sample, as well as the characteristics of patients. Methods: A cross-sectional study using randomized population sample was carried out during 2004/2005, in the Midwest region of the state of São Paulo. Participants were evaluated according to demographic variables and ocular examination. Results: The frequency of occurrence of chalazion was 1.56‰, more common in women, people with astigmatism or low hyperopia, with wide variation in age of onset. It was necessary to prescribe optical correction and surgery in a significant number of cases. Conclusion: The chalazion has low frequency of occurrence in the general population. It occurs predominantly in women and there is a significant association with refractive error.

Prevalence of low serum vitamin a levels in young children with chalazia in southwest china.

PURPOSE: To detect risk factors that may be related to chalazia in children in southwest China. DESIGN: Prospective case-control study. METHODS: The case group, 88 children with chalazia, was divided into 2 subgroups. One had 48 children 6 months to 6 years of age (defined as young children), and the other had 40 children 7 to 12 years of age (defined as older children). The control group consisted of 40 young children and 32 older children. Clinical findings for patients were recorded. Serum was tested for concentrations of vitamin A, vitamin D3, and immunoglobulin E. RESULTS: World Health Organization definitions were used for vitamin A deficiency (< 0.7 µmol/L) and marginal vitamin A deficiency (0.7 to 1.05 µmol/L). The average level of serum vitamin A in the case group was significantly lower than that in the control group (P < .001). Analyses failed to find significant differences in vitamin D3 or immunoglobulin E levels between the case and control groups. The average vitamin A level in young children with multiple chalazia (0.65 ± 0.12 µmol/L) was low. Blepharitis was less prevalent than low serum vitamin A levels in the young child subgroup (odds ratios, 8.5 and 96.9, respectively), but higher than in older children (odds ratios, 17.5 and 9.0, respectively). CONCLUSIONS: Low serum vitamin A is associated with a chalazion in young children in southwest China, especially young children with multiple chalazia.

High prevalence of demodex brevis infestation in chalazia.

PURPOSE: To investigate the correlation between demodicosis and chalazia in patients with the latter. DESIGN: Prospective, observational, comparative study. METHODS: Forty-four adult and 47 pediatric patients with chalazia and 34 adult and 30 pediatric age- and sex-matched patients without chalazia treated at an institutional referral eye center were included. All 155 patients underwent lash sampling followed by microscopic identification and counting of Demodex mites. All 91 patients with chalazia underwent surgical removal, and among them, 74 were followed up for 18 ± 4.3 months after surgery. Statistical correlation between ocular demodicosis and chalazia and its postoperative recurrence was performed. RESULTS: Demodicosis was significantly more prevalent in chalazia patients than in control patients as a group (69.2% vs 20.3%) and when separated into pediatric (70.2% vs 13.3%) and adult (68.2% vs 26.5%) subgroups (all P < .001). Demodicosis was associated strongly with chalazia (odds ratio, 4.39; 95% confidence interval, 2.17 to 8.87; P < .001). D. brevis was significantly more prevalent (odds ratio, 18.21; 95% confidence interval, 2.22 to 149.74; P = .01) than D. folliculorum (odds ratio, 2.82; 95% confidence interval, 1.16 to 6.84, P = .02) in patients with chalazia. Patients with demodicosis tended to demonstrate recurrence (33.3% vs 10.3%; P = .02), especially in those with D. brevis (35.1% vs 13.5%; P = .03). CONCLUSIONS: There is a high prevalence of demodicosis, especially cases of caused by D. brevis, in adult and pediatric patients with chalazia, suggesting that ocular demodicosis is a risk factor for chalazia.

IFAG and childhood rosacea: a possible link?

Idiopathic facial aseptic granuloma (IFAG) is a disorder that usually occurs during early childhood. Its pathogenesis remains poorly understood. The objective of this study was to investigate possible relationships between IFAG and childhood rosacea. This was a retrospective multicenter study of patients attending four French dermatologic centers diagnosed with IFAG between October 2000 and July 2007. Patients and their parents were asked to come for a follow-up visit or to make an appointment for a telephone interview. Clinical symptoms of childhood rosacea were recorded: flushing, permanent or recurrent erythema; facial telangiectasia; papules and pustules on the face without comedones or microcysts; preferential location of the lesions on the convexity of the face; and ophthalmologic involvement of rosacea (recurrent chalazions, conjunctival hyperemia, keratitis). Thirty-eight patients, 20 girls and 18 boys, were included in the study. The median age at the time of diagnosis of IFAG was 43 months, with a median follow-up of 3.9 years. Sixteen patients (42.1%) had at least two criteria of childhood rosacea, 11 of 32 (34.4%) with a single lesion and 5 of 6 (83.3%) with multiple lesions. Children with IFAG are at risk for childhood rosacea, and follow-up is advised, including periodic ophthalmologic assessment.

Associated morbidity of chalazia.

PURPOSE: Chalazion may be associated with some local and systemic conditions. We studied the prevalence of various conditions among patients with chalazion. METHODS: A retrospective observational case-control study of all the members who were diagnosed with chalazion in the Central District of Clalit Health Services in Israel (years 2000-2008; n = 9119) and 9119 age- and gender-matched controls randomly selected from the district members. We calculated the prevalence of various ocular, systemic, and demographic conditions as risk factors for chalazion. RESULTS: Demographically, a significant (P < 0.0001) tendency to develop chalazion was found in the population of lower socioeconomic class, in the population living in urban areas, in young females (10-29 years), in older men (older than 60 years), and in non-Ashkenazi Jews. The following risk factors of chalazion were statistically significant: blepharitis [odds ratio (OR), 6.2], rosacea (OR, 2.9), gastritis (OR, 1.4), anxiety (OR, 1.5), irritable bowel syndrome (OR, 1.7), and smoking (OR, 1.2). Diabetes (OR, 0.8) and hypothyroidism (OR, 0.8) were significantly less prevalent among chalazion patients. CONCLUSIONS: Some systemic conditions are significantly more prevalent and some are significantly less prevalent among patients with chalazion. Better understanding of the pathophysiological association between those diseases and chalazion may help in its treatment and prevention.

Eyelid tumors: histopathological and clinical study performed in County Hospital of Oradea between 2000-2007.

The work assessment is to analyze eyelid tumors diagnosed in the last years in our hospital. We found 471 tumoral and pseudotumoral cases, in which malignant tumors predominated, with 255 cases. The most affected age range was the sixth decade and the majority of tumors were located to lower eyelid. The histopathological study allowed us to establish the lesions type and subtype. The Meibomian gland cysts, squamous papillomas and basal cell carcinomas were the most frequent related with this three of category lesions represented by pseudotumors, benign tumors and malignant tumors. Early diagnosis of these lesions can determine a favorable prognosis, especially in cases of malignant tumors.

A study of ocular infections amongst primary school children in Delhi.

The present study of ocular infections was conducted amongst primary school children residing in an urban slum and rural area of Delhi. A total of four schools were selected, two from urban slum in Central Delhi Rouse Avenue and two from a peripheral village on the outskirts of Delhi. All the children studying in the above mentioned schools and residing in the same area were covered. All the study subjects were interviewed, clinically examined and given a proforma to be filled by their parents. Of the total 775 subjects only 91 (11.74%) had ocular infections. Conjunctivitis was the most prevalent infection followed by trachoma, stye, blepharitis and chalazion. The type and prevalence of infection was similar, in both sexes and both areas, rural and urban. There was a significant rising trend of ocular infection with increase in age. A significant association was found between ocular infections and religion but the association with per capita income was not significant.

Neoplasias malígnas das pálpebras na Faculdade de Medicina de Botucatu / Lid malign neoplasms in Botucatu Medical School

Estudou-se a ocorrência de neoplasias palpebrais malígnas na Faculdade de Medicina de Botucatu de 1978 a 1988. Neste período encontramos 89 tumores malígnos nas pálpebras, sendo 77,53//Ca basocelular, 12,36//Ca espinocelular, 7,86//Ca basoespinocelular e 2,25//Ca meibomiano. A maioria dos pacientes apresentava mais de 40 anos, trabalhava ao sol e 55,05//eram masculinos. O exame histopatológicos foi importante para esclarecimento diagóstico em vários casos