Hailstone

Fabian Dupont is a freelance writer in the medical department. The human medicine specialist is already doing scientific work in Belgium, Spain, Rwanda, the USA, Great Britain, South Africa, New Zealand and Switzerland, among others. The focus of his doctoral thesis was tropical neurology, but his special interest is international public health and the comprehensible communication of medical facts.

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The hailstone (chalazion) is a chronic inflammation of the sebum glands on the edge of the eyelids. The slow swelling of the sebum glands creates a firm, easily movable lump on the upper or lower eyelid. In contrast to the stye (hordeolum), the signs of inflammation in hailstones are not very pronounced and there is no pain. Only a feeling of pressure can be felt. You can find out more about the hailstone here.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. H00

Hailstone: description

The hailstone occurs when the ducts of a sebum gland (meibomian gland or meibomian gland) clog up on the edge of the eyelid. Bacteria and the body's own enzymes break down fat components in the ducts. These breakdown products get into the surrounding tissue and trigger a slow, chronic inflammatory reaction. This attracts immune cells to the eyelid and a hard knot forms over the course of several weeks.

Since an infection with bacteria is not responsible for the immune reaction, but the body's own degradation products are behind it, the hailstone does not cause pain (in contrast to the stye). However, it can be uncomfortable 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 sliding lump on an eyelid. It grows slowly over several days to weeks and is not painful. The conjunctiva on the inside of the lid may be slightly red. Basically, however, only the skin of the eyelids 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; multiple hailstones in one eye are rare.

In some cases, a chalazion is later infected by bacteria. This can no longer be distinguished from the painful, reddened stye, which is very sensitive to the touch.

Hailstone: Causes and Risk Factors:

The accumulation of secretion on the lid, which is the basis of the hailstone, can occur spontaneously, but it can also be caused by many other factors. For example, similar to acne, the sex hormones also affect sebum production in hailstones. Since the full hormone effect on sebum production does not come into play until after puberty, adults are more likely to develop chalazion than children.

Other inflammations of the eye such as conjunctivitis and the skin disease rosacea (rosacea or copper rose) can also promote chalazion. In general, all factors that hinder the flow of sebum increase the risk of hailstones.

In the case of recurring sebum inflammation on the eye, the attending physician should rule out some rarer causes. These include diabetes (diabetes mellitus) and an immune deficiency. In very rare cases, an eyelid tumor can also impede the flow of sebum and thus cause hailstones.

Hailstone: examinations and diagnosis

The symptoms that the patient describes (in the anamnesis discussion) and the examination of the swelling on the edge of the eyelid are usually sufficient for the doctor to diagnose “hailstone”.

During the examination, the doctor pays attention to whether there are any signs of a complication. As a rule, a hailstone on the eye is not an emergency, and there are no dangerous developments.

Hailstone: treatment

Unlike a bacterial infection, treatment for a hailstone takes longer. As a rule, one first tries to clear the accumulation of secretion with dry, warm compresses and regular eyelid massages. To speed healing, the doctor sometimes recommends anti-inflammatory agents, ointments, gels, or eye drops for a hailstone. Home remedies (such as lukewarm eye baths and dressings with various herbs) as well as homeopathic treatment options can support the healing process.

If a bacterial infection has also developed, the doctor will prescribe an eye ointment containing antibiotics.

In most cases, these conservative therapeutic measures are sufficient for the chalazion to regress on its own within several weeks. If that doesn't happen, a surgeon can remove the hailstone. He opens the chalzion through a small incision in the skin and clears out the inflamed tissue. Factors in favor of such a chalazion op are:

• Feeling of pressure
• external disturbing finding
• Influence on visual function
• Suspected malignant degeneration

The hailstone surgery is performed under local anesthesia and involves only minor risks. It is important that the chalazion is completely cleared out, otherwise it can form again.

Hailstone: disease course and prognosis

A hailstone is often perceived as very annoying by patients, especially for cosmetic reasons. It develops slowly over several weeks, and healing usually takes a long time. Overall, however, the prognosis for hailstone is very good.

In rare cases, the hailstones press on the eye and can impair vision. This is most likely to be the case in children and then requires prompt treatment. Because the visual function is very important for the learning process and the development of the brain in young children. If one 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 that the course in adults is usually benign.

In rare cases, the hailstone can be a sign of another disease, for example if someone is receiving more hailstones despite consistent therapy. Then, among other things, a (malignant) tumor must be excluded as the cause.

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