Original Research Article http://doi.org/10.18231/j.ijooo.2019.016 IP International Journal of Ocular Oncology and Oculoplasty, April-June 2019;5(2):61-64 61 A comparative study of intralesional triamcinolone injection in primary chalazion in children and adults Jagriti Rana 1 , Santosh Kumar 2 , Mimansaa Agasti 3* 1,2 Associate Professor, 3 Senior Resident, Dept. of Ophthalmology, Moti Lal Nehru Medical College, (Affiliated to King George Medical University), India *Corresponding Author: Mimansaa Agasti Email: obviouslymimansaa@gmail.com Abstract Introduction: A chalazion is a chronic, sterile lipo-granulomatous inflammatory lesion caused due to the blocked sebaceous secretion from the Meibomian and other sebaceous glands. Its painless and harmless, until it becomes an enlarged upper lid chalazion producing mass effect on the cornea leading to blurred vision and astigmatism. Aim: The aim of our study was to inject 0.1 ml of triamcinolone intralesionally and compare the results in both paediatric and adult age group. We assessed how much time was required for the regression of the lesion and how many patients were in the need for re-injection. We also assessed the need for incision and curettage in such patients. Materials and Methods: Sixty-seven patients were included in the study, out of which 23 were children and 44 were adults. 0.1 ml of triamcinolone (40 mg/dl) was injected intralesionally using a 26 gauge needle. The eyelid was everted and the injection was given transconjunctivally into the centre of the lesion. The eye was not patched. Results: Most lesions resolved within 1 week, the maximum time being 3 weeks in both study populations. Repeat injection was needed in only 1 case in paediatric age group and 15 cases in adult age group. None of our patients developed any adverse effects. Conclusion: Usually, chalazion is a self-limiting disease and intralesional injection of triamcinolone is a very effective modality for treatment. It can be done under topical anaesthesia, causing much less bleeding and the risk of scarring is almost not there. It is a very quick procedure, performed in a sterilized out-patient setting, requires no special instruments and is very less painful. Its safely tolerated by both children and adults and should be considered as a preferable procedure over incision and curettage. Keywords: Intralesional, Chalazion. Introduction A chalazion is a chronic granulomatous inflammation of the eyelid which is caused by blockage of the openings of the meibomian glands. 1 It presents as a firm, benign, localized, painless mass in the eyelid, usually affecting the upper eyelid more than the lower eyelid. There is no sex predilection. 2 It frequently causes symptoms such as irritation and inflammation. Corneal astigmatism and mechanical ptosis can also result from a large chalazion 3 . Hypermetropia has been also reported. 4 It can get secondarily infected and result in a painful swelling. 5 There may be variation in the histopathological appearance but typically the histopathology comprises of a granuloma rich in epithelioid cells, giant cells, lymphocytes, neutrophils and eosinophils. 6 Certain conditions like seborrhoeic dermatitis, acne rosacea and chronic blepharitis, are factors that predispose to the formation of chalazion. 7 Chalazion may also be caused by a few viruses. 2 Most chalazia resolve spontaneously but the rest need some form of treatment. 8,9 The usual way to treat a chalazion are incision and curettage (I & C) which is also a standard treatment 10 . Although, this is an extremely effective way to treat a chalazion, but this can be discomforting and painful to a patient. Also, after I & C, wearing a pad and bandage is required. Intralesional triamcinolone injection is known to hasten the resolution of the chalazion. 11 This modality is especially useful in children and in chalazia involving the lid margin or close to the punctum and even in multiple chalazia at the same site. 12 If the lesion does not regress with a single injection of triamcinolone, a second injection is repeated after 6 weeks. 10 I & C is performed in patients who do not respond to a second injection. The purpose of this study was to determine the differences of using intralesional triamcinolone acetonide injection for treating primary chalazion in adults and children. Materials and Methods This was a randomised, prospective study conducted at our centre between September 2015 and March 2017. The study was undertaken after ethical clearance was obtained from the Institutional Review Board. Sixty-seven patients were included in the study, out of which 23 were children and 44 were adults. All injections were given by a single ophthalmologist (SR). The inclusion criteria included both male and female patients of all ages (classified later as paediatric group less than 18 years of age and adult group, more than 18 years of age). Patients with primary single chalazion on each lid were chosen. Exclusion criteria included recurrent chalazion, abnormal surrounding lid tissue and other features indicating malignancy. Also, patients having hypersensitivity to any of the drugs used in the study. Patients having adnexal infection were not included in the study.