Hailstone: Description
The hailstone occurs when the excretory ducts of a sebaceous gland (meibomian gland or meibomian gland) at the edge of the eye lid become blocked. Bacteria and the body’s own enzymes break down fatty components in the excretory ducts. These breakdown products leak into the surrounding tissue and trigger a slow, chronic inflammatory response. This attracts immune cells to the eyelid, and a hard nodule forms over the course of several weeks.
Since no infection with bacteria is responsible for the immune reaction, but rather the body’s own degradation products are behind it, the hailstone does not cause any pain (unlike the stye). However, it can press unpleasantly on the eye. Ultimately, however, it is mostly aesthetic reasons why those affected go to the doctor to have a hailstone treated.
Hailstone: Symptoms
A hailstone manifests as a shifting lump on an eyelid. It grows slowly over several days to weeks and does not cause pain. The conjunctiva inside the eyelid may be slightly red. Basically, however, only the eyelid skin is affected by the hailstone. The eye itself and surrounding structures do not swell. There are also no other symptoms such as fever.
A chalazion usually occurs singly; several hailstones on one eye are rather rare.
Hailstone: causes and risk factors:
The congestion of secretions on the eyelid that underlies hailstones can occur spontaneously, but it can also be caused by many other factors. For example, similar to acne, sex hormones influence sebum production in hailstorm. Since the full hormonal effect on sebum production only comes into play after puberty, adult people are more likely to develop chalazion than children.
Other inflammations of the eye, such as conjunctivitis, as well as the skin condition rosacea (or copper rosacea) can also promote chalazion. In general, all factors that impede the flow of sebum increase the risk of a chalazion.
In cases of recurrent sebaceous gland inflammation of the eye, the treating physician should rule out some rarer causes. These include diabetes mellitus and immune deficiency. In very rare cases, a tumor of the eyelid can also obstruct the flow of sebum and thus cause a hailstone.
Hailstone: examination and diagnosis
The complaints that the patient describes (in the anamnesis interview) and the examination of the swelling at the edge of the eyelid are usually sufficient for the doctor to make the diagnosis “hailstone”.
Hailstone: Treatment
Unlike a bacterial infection, the treatment of a hailstone takes longer. As a rule, one first tries to clear the congestion of secretions with dry, warm compresses and regular eyelid massages. To speed up healing, the doctor sometimes recommends anti-inflammatory ointments, gels or eye drops for a hailstone. Home remedies (such as lukewarm eye baths and compresses with various herbs) and homeopathic treatment options can help the healing process.
Home remedies have their limitations. If the symptoms persist over a longer period of time, do not get better or even get worse, you should always consult a doctor. If a bacterial infection has also developed, the doctor will prescribe an eye ointment containing antibiotics.
The concept of homeopathy and its specific effectiveness are controversial in science and not clearly proven by studies.
In most cases, these conservative therapeutic measures are sufficient for the chalazion to regress on its own within several weeks. If this does not happen, a surgeon can remove the chalazion. Through a small skin incision, he opens the chalazion and clears out the inflamed tissue. Factors in favor of such chalazion surgery are:
- Feeling of pressure
- external disturbing findings
- Interference with the visual function
The chalazion surgery is performed under local anesthesia and carries little risk. It is important that the chalazion is completely cleared out, otherwise it may form again.
Hailstone: course of the disease and prognosis
A chalazion is often considered very bothersome by patients, mainly for cosmetic reasons. It develops slowly over several weeks, and healing usually also takes a long time. Overall, however, the prognosis for hailstones is very good.
In rare cases, the hailstone presses on the eye and can limit vision. This is most likely to occur in children and then requires prompt treatment. This is because visual function is very important in young children for the learning process and brain development. If an eye is not involved in the visual process for several days or weeks due to a hailstone, there is a risk of long-term visual damage. This is not the case in adults, so the course in adults is usually benign.
In rare cases, the hailstone can be a sign of another disease, such as when someone gets more hailstones despite consistent therapy. Then, among other things, a (malignant) tumor must be ruled out as the cause.
