What is the management for a persistent chalazion?

• A. Immediate systemic antibiotics.
• B. Laser therapy.
• C. Observation only.
• D. Surgical excision if it does not resolve on its own.

Answer: (D)

A chalazion that persists after initial conservative care is best treated with definitive removal. When a chalazion remains despite warm compresses and lid hygiene, it signals a chronic granulomatous obstruction of a meibomian gland. Removing the lesion surgically with incision and curettage directly eliminates the granulomatous tissue, provides rapid resolution, and reduces the chance of recurrence compared with waiting longer. It’s typically done as an outpatient procedure under local anesthesia, offering a durable solution.

Systemic antibiotics aren’t indicated unless there’s an accompanying infection, and laser therapy isn’t the standard treatment for a persistent chalazion. Simply observing a lesion that has not resolved isn’t appropriate, as the goal is definitive management to prevent ongoing symptoms or recurrence.