Sterile, chronic, inflammatory granuloma of the eyelid caused by a foreign body reaction to sebum within a meibomian gland

Aetiology

• Can occur in all age groups but are thought to be most common in adults
• Risk factors include pregnancy, blepharitis and seborrhoeic dermatitis

Pathophysiology

• The meibomian glands (located in the tarsal plate) are a set of glands that run along the eyelid margin
• They produce a lipid secretion which provides the lipid layer of the tear film
• Obstruction of the gland duct causes the gland to enlarge and to rupture, releasing the accumulated lipid contents into the surrounding eyelid soft tissue
• This triggers an inflammatory reaction against the lipid content which subsides with time
• Consequently, the meibomian cyst often becomes painless and non-tender

Clinical features

• Firm, painless, localized eyelid swelling that has developed slowly over several weeks

Management

• Warm compresses for several weeks
• Most meibomian cysts resolve spontaneously or with conservative managment, although this may take weeks or months
• Management of any co-existing risk factors to reduce risk of recurrence