Definition
Kalazion is, granulomatous inflammation of the gland meibom, due to the blockage. At kalazion, meibom gland blockage with a mild infection that resulted in chronic inflammation of the gland.
Initially, it can be mild inflammation and tenderness like hordeolum-differentiated from hordeolum because there are no signs of acute inflammation.
Pathophysiology
Kalazion will give the symptoms of a lump on the eyelid, no hyperemia, no tenderness, and there pseudoptosis. Preaurikuler gland, not enlarged. Sometimes result in changes in the form of eyeballs Caused by pressure, resulting in abnormalities of the refraction of the eye.
Damage to lipids, resulting in glandular secretion retention, probably caused by an enzyme from the bacterium, forming granulation tissue, and Causing inflammation. This granulomatous process that distinguishes between kalazion with internal or external hordeolum (especially the pyogenic process that causes pustules), although kalazion can cause hordeolum, vice versa. Clinicaly, a single nodule rather loud, located deep in the palpebra, or on the tarsal. Eversion meibom palpebra may show dilated glands.
Kalazion occur at any age, while at the extreme age are very rare, pediatric cases may be encountered. Sabaseous hormonal influence on the secretion and viscosity may account for the accumulation at puberty and during pregnancy.
etiology
Kalazion may arise spontaneously due to the blockage of the gland or secondary channels of hordeolum internum. Kalazion associated with seborrhea, chronic blepharitis, and acne rosacea.
Clinical symptoms of
Patients usually present with a brief history of complaints on palpebra, followed by acute inflammation (eg red, swollen, softening). Often there is a history of similar complaints in the past, because kalazion have a tendency to recur in certain individuals. Kalazion more often arise in, palpebra superior, where the number of Meibom glands there are more than palpebra inferior. Thickening of the channel Meibom glands can also cause dysfunction of the glands of Meibom. This condition appears with an emphasis on the eyelid that would cause a white discharge such as toothpaste, which should have only a small amount of clear oily liquid. Kalazion associated with dysfunction and obstruction of sebaceous glands in the skin (such as blackheads, oily). Also possible, there are acne rosacea redness of the face (facial erythema), teleangiektasis and spider nevi on the cheeks, nose, and skin palpebra.
Treatment
Kalazion treatment include
1. Using warm compresses for about 15 minutes, 2-4 times a day
Kalazion conservative treatment is to compress the warm water 15 minutes (4 times daily). More than 50% kalazion cured with conservative treatment. Eye drops or ointment if the infection is thought to be the cause.
2. Injection of steroids to reduce inflammation
Steroid injection into the kalazion to reduce the inflammation, if there is no evidence of infection. Steroids stop the inflammation and often leads to regression of kalazion in a few weeks later. Injection of 0.2 to 2 mL triamcinolone 5 mg / ml directly to the center kalazion, re-injections may be needed. Complications of steroid injection include hipopigmentasion, atrophy, and potential infection.
3. Surgery, if the lump can not be lost.
a. excision kalazion
- If necessary, make a vertical incision on the surface of the conjunctiva palpebra.
- For a small kalazion, do curettage on inflammatory granuloma in the eyelid.
- For large kalazion, iris granuloma to be discarded entirely Cauter or disposal meibom gland (the usual)
- For kalazion that protrude into the skin, the skin surface horizontal incision is more often performed than through the conjunctiva to the disposal of all inflamed tissue.
b. Eskokleasi Kalazion
- First, given a topical anesthetic eye drops. pantocaine. Infiltrative anesthesia medicine is injected under the skin in front of kalazion. Kalazion clamped with a clamp and then clamp kalazion reversed so that the tarsal and kalazion konjungitva visible. Incision made perpendicular margo palpebra and then the contents of kalazion curette, until clean. Kalazion clamps removed and put eye ointment.
Complication
Damage to the drainage system at kalazion can cause trichiasis, and loss of eyelashes. Kalazion recurrent or look atypical need to be biopsied to exclude malignancy. Astigmatism can occur if the mass of the palpebra already changed the contour of the cornea. Kalazion the drainage only partially can cause prolapse mass of granulation tissue over the conjunctiva or skin.
Prognosis
Therapy is usually successful. If new lesions are frequent, inadequate drainage that may bind these local recurrences. Kalazion untreated terdrainase sometimes spontaneously, but usually more often persistent to intermittent acute inflammation.
If there is kalazion repeated several times histopathological examination should be performed to avoid misdiagnosis with the possibility of malignancy.
Kalazion is, granulomatous inflammation of the gland meibom, due to the blockage. At kalazion, meibom gland blockage with a mild infection that resulted in chronic inflammation of the gland.
Initially, it can be mild inflammation and tenderness like hordeolum-differentiated from hordeolum because there are no signs of acute inflammation.
Pathophysiology
Kalazion will give the symptoms of a lump on the eyelid, no hyperemia, no tenderness, and there pseudoptosis. Preaurikuler gland, not enlarged. Sometimes result in changes in the form of eyeballs Caused by pressure, resulting in abnormalities of the refraction of the eye.
Damage to lipids, resulting in glandular secretion retention, probably caused by an enzyme from the bacterium, forming granulation tissue, and Causing inflammation. This granulomatous process that distinguishes between kalazion with internal or external hordeolum (especially the pyogenic process that causes pustules), although kalazion can cause hordeolum, vice versa. Clinicaly, a single nodule rather loud, located deep in the palpebra, or on the tarsal. Eversion meibom palpebra may show dilated glands.
Kalazion occur at any age, while at the extreme age are very rare, pediatric cases may be encountered. Sabaseous hormonal influence on the secretion and viscosity may account for the accumulation at puberty and during pregnancy.
etiology
Kalazion may arise spontaneously due to the blockage of the gland or secondary channels of hordeolum internum. Kalazion associated with seborrhea, chronic blepharitis, and acne rosacea.
Clinical symptoms of
Patients usually present with a brief history of complaints on palpebra, followed by acute inflammation (eg red, swollen, softening). Often there is a history of similar complaints in the past, because kalazion have a tendency to recur in certain individuals. Kalazion more often arise in, palpebra superior, where the number of Meibom glands there are more than palpebra inferior. Thickening of the channel Meibom glands can also cause dysfunction of the glands of Meibom. This condition appears with an emphasis on the eyelid that would cause a white discharge such as toothpaste, which should have only a small amount of clear oily liquid. Kalazion associated with dysfunction and obstruction of sebaceous glands in the skin (such as blackheads, oily). Also possible, there are acne rosacea redness of the face (facial erythema), teleangiektasis and spider nevi on the cheeks, nose, and skin palpebra.
Treatment
Kalazion treatment include
1. Using warm compresses for about 15 minutes, 2-4 times a day
Kalazion conservative treatment is to compress the warm water 15 minutes (4 times daily). More than 50% kalazion cured with conservative treatment. Eye drops or ointment if the infection is thought to be the cause.
2. Injection of steroids to reduce inflammation
Steroid injection into the kalazion to reduce the inflammation, if there is no evidence of infection. Steroids stop the inflammation and often leads to regression of kalazion in a few weeks later. Injection of 0.2 to 2 mL triamcinolone 5 mg / ml directly to the center kalazion, re-injections may be needed. Complications of steroid injection include hipopigmentasion, atrophy, and potential infection.
3. Surgery, if the lump can not be lost.
a. excision kalazion
- If necessary, make a vertical incision on the surface of the conjunctiva palpebra.
- For a small kalazion, do curettage on inflammatory granuloma in the eyelid.
- For large kalazion, iris granuloma to be discarded entirely Cauter or disposal meibom gland (the usual)
- For kalazion that protrude into the skin, the skin surface horizontal incision is more often performed than through the conjunctiva to the disposal of all inflamed tissue.
b. Eskokleasi Kalazion
- First, given a topical anesthetic eye drops. pantocaine. Infiltrative anesthesia medicine is injected under the skin in front of kalazion. Kalazion clamped with a clamp and then clamp kalazion reversed so that the tarsal and kalazion konjungitva visible. Incision made perpendicular margo palpebra and then the contents of kalazion curette, until clean. Kalazion clamps removed and put eye ointment.
Complication
Damage to the drainage system at kalazion can cause trichiasis, and loss of eyelashes. Kalazion recurrent or look atypical need to be biopsied to exclude malignancy. Astigmatism can occur if the mass of the palpebra already changed the contour of the cornea. Kalazion the drainage only partially can cause prolapse mass of granulation tissue over the conjunctiva or skin.
Prognosis
Therapy is usually successful. If new lesions are frequent, inadequate drainage that may bind these local recurrences. Kalazion untreated terdrainase sometimes spontaneously, but usually more often persistent to intermittent acute inflammation.
If there is kalazion repeated several times histopathological examination should be performed to avoid misdiagnosis with the possibility of malignancy.
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