While blepharitis itself is treated medically, the complications it causes—such as cysts (chalazia) or misdirected lashes (trichiasis)—often require surgical intervention.
Incision and Curettage (Chalazion Removal)
A chalazion is a firm, painless lump caused by a blocked oil gland. If it does not resolve with warm compresses after a few weeks, it can be drained surgically.
- Anesthesia: A small injection of local anesthetic is given into the eyelid (this stings for about 10 seconds).
- The Cut: A small clamp is placed on the lid. The incision is usually made from the inside of the eyelid, so there is no visible scar.
- The Cleanout: The contents of the cyst are scooped out (curettage) and the cyst wall is removed.
- Recovery: The eye may be padded for a few hours. Some bruising is normal for a few days.
Alternatively, a steroid injection (Triamcinolone) can be injected directly into the lump to speed up resolution without cutting.
Trichiasis Management (Lash Removal)
Chronic inflammation can scar the follicle, causing lashes to grow inward and scratch the cornea.
1. Epilation
Plucking the offending lash with forceps. This provides immediate relief, but the lash usually grows back in 4-6 weeks.
2. Electrolysis
An electric current is applied to the hair follicle to kill it permanently. This is useful for a small number of rogue lashes.
3. Cryotherapy
Freezing the eyelid margin to destroy multiple lash follicles. This is used for more extensive areas of misdirected lashes.
Ectropion / Entropion Repair
Long-term watering and wiping of the eyes can cause the eyelid skin to stretch.
- Ectropion: The lid sags outwards. Tears pool and spill over the cheek.
- Entropion: The lid rolls inwards. The skin and lashes rub against the eye.
Both require oculoplastic surgery to tighten the eyelid tendon (Lateral Tarsal Strip procedure) and restore the normal position of the lid.
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FAQs
When is surgery needed for blepharitis complications?
It is considered when chalazia, trichiasis, or lid malposition persist despite medical management.
What is the recovery time after chalazion surgery?
Most patients return to normal activities quickly, with mild bruising or swelling for a few days.
Do lashes grow back after epilation?
Yes. Plucked lashes often regrow within weeks, which is why repeat treatment may be needed.
Is surgery available on the NHS?
Availability varies by region and clinical policy. Your GP or optometrist can advise on referral pathways.