Chalazion Draining From Underside of Lid

[Kathy44823]

Has anyone had a chalazion drain onto the eyeball through the underside of the eyelid? I've had one for a little over 7 weeks now. It's being treated with neo/poly/dex and erythromycin for 5 of those weeks. It was very large and inflamed at first but now is much smaller. I went to see an ophthalmologist because there were massive amounts of gooey stuff in my eye several times from an apparent eye infection and the chalazion was very large and inflamed with pulsating pain at that time.  I was prescribed neo/poly/dex 4X a day, and it worked great at clearing up the gooey messes in my eye, but 2 weeks after the 7 day course was finished the gooey mess in my eye returned.  
I called the doctor's office and told them about it. They set up another appointment at that point.  On the day of my appointment, the doctor's office called me and said not to come, the dr. didn't need to see me. I got into a different local ophthalmologist that same day. He added erythromycin to the regimen and at this point I have been using both of these for 22 days straight with instructions to continue this regimen for another 12 days until my next appointment - Neo/poly/dex 4X and Erythormycin 2 of those times. I've been doing hot compresses with a washcloth 4 times a day. There have been no further gooey mess in my eye since shortly after starting this new regime.

I see my doc again 12 days from now and I believe that he wants to drain the chalazion at that appointment. . He put "possible procedure" on the appointment sheet but didn't actually say anything to me.  I'm not sold on the idea. I've been using warm compresses but it seems so slow, not even a pinpoint amount most days. A few days ago, I used my microwavable eye mask and then found about 1/4 inch of white stuff coming out of the bottom corner of the eyelid, as if it came from the underside of the chalazion.  I'm wondering if this is normal or if it might spread infection. It seems like using the mask would be more effective but I only did that one time because of my concerns about where the 1/4 inch of white discharge came from and what it meant. Thanks!

[John C Hagan III, MD, FACS, FAAO]

Kathy, everything you describe is common with chalazions (actuallly chalazia). Most drain posterior behind the lid. I have my patients use the microwave eye mask (generally the Bruder brand).  It it better that 'white stuff' comes out of the chalazion than stay within it (think draining a boil or expressing a blackhead).  I tell my patients "Your chalazion will not go away nearly as fast as you want but over 6-8 weeks most are gone or so small that they cannot be seen or do they drain. The one thing I would add is that the most common cause is oil building up on the edge of the lid from the oil glands in the lid. This is called blepharitis. I suggest you consider using an eyelid cleaner to remove this debris and oil and prevent more from developing. Some people with oily lids have multiple chalazia.  This is my preferred brand:  https://www.ocusoft.com/?gclid=CjwKCAjwu5yYBhAjEiwAKXk_eMw3Os2UEAKJogs0x_G3OTnVJ5RriJEKPhOdoRqC67l02Y2DeAzkqBoCdbMQAvD_BwE

[Kathy44823]

Thank you so very much, Dr. Hagan.  I have ordered both of the items that you recommend.  

[John C Hagan III, MD, FACS, FAAO]

You are welcome and thanks for saying thanks. Very few do.