Common eye conditions

Chalazion (Meibomian Cyst)

Chalazion (meibomian cyst): the eyelid lump that will not go away

A chalazion is a firm, usually painless lump in the eyelid. It forms when one of the meibomian glands — the oil glands that run through the lid — blocks, and the trapped oil sets off a slow inflammatory reaction in the surrounding tissue. It is sometimes called a meibomian cyst. Chalazia are common, they are not dangerous, and most settle with a few weeks of the right home care. Rose Optometry in Frankton, Hamilton, sees and treats them every week, and, more usefully, treats the blocked glands that cause them so they stop coming back.

Book online: a Dry Eye Evaluation is the right appointment for a chalazion — it examines the lid and the glands behind it; the appointment is preselected, just choose a time. If the lump is painful, red and getting bigger quickly, phone 07 847 3195 instead. For a child, please phone.

What a chalazion looks and feels like

  • A round, firm lump in the upper or lower lid, anywhere from a grain of rice to a pea in size.
  • Usually painless once established, though it can be tender in the first days.
  • Comes up over a week or two and then sits there — for weeks, sometimes months.
  • Redness on the inside of the lid over the lump, sometimes visible when the lid is pulled down.
  • A large upper-lid chalazion can press on the eye and blur vision slightly.
  • It often follows a stye that stopped hurting but never fully went away.

Chalazion vs stye

A stye is an infection: painful, red, quick to appear, often with a head, and gone in a week or two. A chalazion is a blockage: firm, slow, mostly painless, and persistent. They are related — an internal stye that does not drain frequently turns into a chalazion — but they are treated differently, which is why it is worth knowing which one you have.

Why chalazia happen

Chalazia are almost always a sign that the meibomian glands are not flowing properly. Thickened oil blocks the gland opening, the gland keeps producing, and the backed-up oil leaks into the lid tissue. The conditions that thicken the oil are meibomian gland dysfunction and blepharitis, and both are common in people with rosacea, seborrhoeic skin, or heavy eye makeup use. One chalazion is bad luck. Two or three in a year is a gland problem that needs treating.

Treating a chalazion

At home: warm compresses and massage

This is the treatment, and it works for most chalazia if it is done properly for long enough. Warm the lid with a compress hot enough to feel but not to burn — a microwaveable heated eye mask holds its temperature far better than a flannel — for ten minutes, three or four times a day. Straight after each compress, massage the lid gently with a clean fingertip, stroking towards the lashes, to encourage the softened oil out of the gland. Clean the lid margin daily with a lid cleanser from our lid hygiene range. Do not squeeze or try to pop it. Keep this up for four weeks before judging it; most chalazia shrink steadily over that time and are gone within six to eight weeks.

In clinic

At a Dry Eye Evaluation we confirm it is a chalazion, check the gland openings and lid margin, and photograph the meibomian glands with meibography to see how many are blocked. From there we can express the affected gland at the slit lamp, prescribe a short course of anti-inflammatory or antibiotic treatment where the lid is inflamed, and, most importantly, treat the underlying gland problem so this is the last chalazion rather than the first of many. Our optometrists are therapeutically qualified and can prescribe where needed.

When it needs a procedure

A chalazion that is still there after six to eight weeks of proper home treatment, that is large enough to affect vision, or that is causing real trouble cosmetically, can be treated by an ophthalmologist with a small procedure under local anaesthetic — usually incision and drainage from the inside of the lid, which leaves no visible scar, or a steroid injection into the lump. We refer directly and follow up afterwards. We do not rush to this; the great majority never need it.

Stopping them coming back

Recurrent chalazia are a meibomian gland problem, and the effective treatments act on the glands: a proper daily warm compress and lid routine, in-clinic gland treatments such as LipiFlow, IPL or Blephasteam, and BlephEx lid cleaning where blepharitis is part of the picture. All of these are available at our dry eye clinic in Hamilton.

When to get a chalazion checked promptly

  • It is painful, red and growing quickly — that is an infection, and it needs seeing.
  • Your vision has changed.
  • It has been there for more than eight weeks despite proper compresses.
  • It keeps coming back in exactly the same spot, particularly if you are over 50 and it does not behave like a typical chalazion. This is uncommon, but a lump that recurs in one place should be examined rather than assumed.
  • It is on a child's lid and is not settling with compresses.

Frequently asked questions

Will a chalazion go away on its own?

Often, yes, but slowly, and much faster with warm compresses and massage done properly. Without any treatment some sit for months.

What are the healing stages of a chalazion?

Typically a tender swelling for a few days, then a firm painless lump, then gradual softening and shrinking over four to eight weeks as the trapped oil is reabsorbed. Occasionally it drains through the skin or the inside of the lid on its own, which is fine.

Can I pop or squeeze a chalazion?

No. It is not a pimple; there is no pocket of pus to release, and squeezing spreads the inflammation and can scar the lid. Warmth and massage, or a proper procedure if it needs one.

Is a chalazion the same as a meibomian cyst?

Yes — same thing, different name.

Can a chalazion be removed at Rose Optometry?

We assess, express glands, prescribe and treat the cause in clinic. Surgical removal is done by an ophthalmologist, and we refer directly when it is needed.

Do I need a referral?

No. Book a Dry Eye Evaluation online or phone us. GPs are welcome to refer.

Rose Optometry, 38 Lake Road, Frankton, Hamilton. 07 847 3195

References

  • Amescua G, Akpek EK, Farid M, et al. Blepharitis Preferred Practice Pattern. Ophthalmology. 2019;126(1):P56-P93. PMID 30366800.
  • Nichols KK, Foulks GN, Bron AJ, et al. The International Workshop on Meibomian Gland Dysfunction: Executive Summary. Invest Ophthalmol Vis Sci. 2011;52(4):1922-1929. PMID 21450913.
  • Goawalla A, Lee V. A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses. Clin Exp Ophthalmol. 2007;35(8):706-712. PMID 17997772.

Rose Optometry's dry eye clinic is led by Jacqueline Rowe — BSc Chemistry, BOptom. Partner Optometrist, Rose Optometry; New Zealand Eye Research Centre. Last reviewed August 2026.

Frequently asked questions

What does an optometrist do?

In NZ an optometrist can calculate the prescription for glasses, fit contact lenses, diagnose and treat eye conditions and infections with medication. They can also manage ocular injuries including removing foreign objects. If surgery or specialist treatment is required they can refer to an ophthalmologist (eye surgeon), hospital, or other health care specialist. NZ-trained optometrists must complete a 5-year degree at the University of Auckland before becoming registered.

What is a dispensing optician (sometimes called a “dispenser”)?

A dispensing optician has formal training in optical dispensing. They are qualified to help a client choose frames, read a prescription, discuss lens options, take measurements, order and fit glasses.

What is an ophthalmologist?

An ophthalmologist is a medical doctor who has specialised in the treatment of serious eye disease and ocular surgery such as cataract removal. They do not typically prescribe glasses or contact lenses.

What payment options do you have?

While payment is generally required on the day of appointment, we do offer a number of payment options including Afterpay, Genoapay, QCard, and GoCardless.

Are you open on public holidays?

No. We are closed on public holidays and long weekends as we believe our staff should have the chance to enjoy this time with friends and family.

How do I know if Rose is the right practice for me?

If your eyes are straightforward, almost any good optometrist can look after you well, and we would rather say that than pretend otherwise. Come to us when something is not straightforward: a prescription that will not settle, a cornea that has changed shape, a child whose short-sightedness is moving faster than it should, an eye surface that has stopped being comfortable, or a diagnosis you have been given but do not understand. Those problems are decided by measurement, and measuring them properly needs instruments most practices do not have.

I have been somewhere else and I still do not know what is going on. Should I come for a second opinion?

Yes, and you do not need to justify it. A second opinion is not a criticism of whoever saw you first — very often they were right, and what you actually needed was the finding explained and the numbers put in front of you. What we can add is measurement. We can image the layers of your cornea and retina, map the epithelium, quantify how far your cornea sits from normal, measure the length of your eye and check your tear film objectively. That turns “something is not right” into a number, and a number either explains the problem or rules it out. Bring any previous scans, prescriptions and letters. Comparison against your own past results is often the most valuable thing in the room.

My case is complicated. Will you take it on?

Usually. Complex is what this practice was built around — keratoconus, corneal grafts, irregular corneas after surgery or injury, severe dry eye, high prescriptions, and eyes that have been told they are not fittable with contact lenses. The Rose K lens for keratoconus was designed in this practice, and lenses of that family are now the most frequently prescribed in the world for the irregular cornea. If we cannot help, we will tell you at the first appointment and tell you who can, rather than taking you through a course of treatment that was never going to work.

My child's short-sightedness is getting worse and I have been told to wait and see. Is that right?

Waiting is the one thing that cannot be undone. Short-sightedness is axial — the eye is physically growing too long — and that length does not come back. What treatment does is slow the rate of growth, so the earlier it starts the more length is saved. We measure axial length directly on two independent biometers and plot it against normal growth curves, which means we can see a child drifting off their expected curve before the prescription changes. There is a free 15-minute myopia chat if you want to understand the options before committing to anything. It is worth being precise about what we are all trying to achieve. Myopia control does not stop a child's eyes changing and no practice should tell a parent it will. What it does, reliably and across many published trials, is slow the rate at which the eye lengthens — and because the risk of retinal detachment, myopic maculopathy and glaucoma in later life rises with every extra millimetre, slowing that growth is how a child is kept out of the range where sight is genuinely at risk. After seventeen years of focusing on this, we are now seeing children on customised plans whose axial length is not progressing at all over a monitoring period, and in some cases measurements that come back slightly shorter than the ones before them. That is our own clinical observation in our own patients rather than a trial result, and it has to be read carefully, because the choroid thickens when treatment is working and part of an apparent reduction can be that thickening rather than the eye itself shortening. That is precisely why we measure both. We are not yet able to tell a parent that we can stop myopia in its tracks, and we will not say it until we can.

I have dry eye and nothing has worked. What is different here?

Two things: we measure it before treating it, and we hold every current treatment technology in one building. Most dry eye is treated on the basis of symptoms, which is why drops so often fail. A tear film can be failing because the oil layer is blocked, because the water layer is short, because the surface is inflamed, or because the lids are the problem, and those need different treatments. We assess the tear film objectively with TearCheck — tear film stability, the oil layer, lid and gland imaging, and an inflammation measure — and measure tear osmolarity, the saltiness of the tears, which is the closest thing to a laboratory number for dry eye. Then we treat the cause. Rose holds intense regulated pulsed light for inflammation and gland function, LipiFlow thermal pulsation to clear blocked meibomian glands from the inner lid surface, Blephasteam controlled-humidity warming, Tixel thermomechanical treatment for the lids, and Rexon-Eye quantum molecular resonance for the more severe and treatment-resistant cases. At the time of writing, and to the best of our knowledge, no other optometrist or ophthalmologist in New Zealand has all of these available under one roof. We say that as a statement of fact rather than a boast, and we would be glad for it to stop being true. Dry eye is one of the most common and most under-treated conditions we see, and there are far more people living with it than one practice can look after. Any practice wanting to build this kind of service has our encouragement and our help — please contact us for co-management, and send us the cases you are not yet set up for. Why holding all of them matters is simple. A practice with one dry eye machine will offer you that machine. Holding all of them means the assessment decides the treatment, rather than the equipment deciding it — and when the first approach does not work, the next one is in the next room rather than in another city.

Do you see very young children?

Yes — from around six weeks of age. Babies and toddlers are tested with Cardiff acuity cards and retinoscopy, neither of which needs the child to read a letter, name a picture or say a word. Most of the findings that matter in a young child cause no symptoms and are invisible to a parent, which is exactly why they need looking for.

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