Ophthalmic Pathology Case Studies


CASE 2: Chalazion


Clinical History:

A 49-year-old man has been bothered an enlarging, painful nodule on his upper eyelid for the past three weeks. His vision is not affected.

Gross and Microscopic Pathology:

This is an inflammatory condition. Grossly, there is swelling in the region of the upper eyelid, below the epidermis. Microscopically, there is marked chronic inflammation with a component of granulomatous inflammation (multinucleated giant cells).

Questions:

  1. What is the diagnosis?

    2. This is a chalazion.

  2. How does this lesion occur?

    3. The inflammation involves the Meibomian glands of the inner eyelid. The Meibomian glands provide a mucinous secretion that contributes to formation the the tear film that protects the eye. Obstruction of the duct draining such a gland can lead to inflammation. With inflammation there is release of lipid from the Meibomian glands that can result in a foreign body granulomatous inflammatory response.

  3. Name another lesion that can occur in this location.

    4. A hordeolum, or "stye" can occur in this location with infection of the eccrine sweat glands or glands of Moll.