The hailstone, also known as chalazion in the technical terminology, is a chronic inflamed area on the eyelid caused by certain congested sebaceous glands, the so-called meibomian glands.
How is a hailstone formed?
The 20 to 30 meibomian glands are distributed in the eyelid itself and end with their excretory ducts at the eyelid edges. If the edge of the eyelid is pulled forward a little, it can be recognized as small yellowish dots arranged side by side. When a duct of the meibomian gland becomes blocked, the sebum produced in the gland cannot flow off and accumulates.
The body’s own defense cells recognize the sebum and try to eliminate it. Eventually, inflammation of the gland occurs. Visually, the inflammation is noticeable as a small thickened area, usually a few millimeters in size and shimmering slightly violet.
Although it is not painful, it is still perceived as disturbing and unpleasant, especially from a cosmetic point of view. There can be many reasons why a hailstone occurs. For example, an inflammation of the eyelid margin (a so-called blepharitis) can prevent the secretion of the glands from draining away or it can also be a chronic conjunctivitis. Diseases in which the sebum production of the gland itself is affected can also be a possible cause, for example acne or diabetes mellitus. In extremely rare cases, a tumor located on the eyelid can also cause the passage to be blocked and the secretion to accumulate due to its size.
Diagnosis
The diagnosis “hailstone” is very easy and quick to make in almost all cases. The (eye) doctor examines the affected eyelid and palpates it. If the examination can be carried out without any problems and is above all painless, the hailstone in question is the aforementioned hailstone. However, if there is pain and the area is not only a little pale violet, but also strongly reddened, it is most likely a barley grain, also called hordoleum.
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