What is the recommended initial treatment for chalazion?

• A. Warm compresses with lid massage bid-qid
• B. Immediate incision and drainage
• C. Systemic antibiotics
• D. Steroid injection

Answer: (A)

Chalazion is a blocked meibomian gland that causes a noninfectious granulomatous swelling. The best initial approach is noninvasive management with warm compresses and lid hygiene, followed by gentle lid massage. Applying a warm compress helps soften the thickened secretions inside the gland and promotes drainage, while a careful lid massage after the warm soak helps express the secretions and relieve the obstruction. Doing this consistently—several times a day—addresses the underlying blockage without procedures or medications.

Antibiotics aren’t needed for an uncomplicated chalazion because the issue is not an active infection, and systemic antibiotics don’t speed resolution. If the chalazion doesn’t improve after a few weeks, or if it’s large or persistent and cosmetically concerning, an ophthalmologist may consider incision and drainage or, less commonly, intralesional steroid injection.