Successful Management of Delayed Postoperative Hemorrhage Following Chalazion Excision Using Oral Tranexamic Acid

A 59-year-old man presented with bilateral chalazia refractory to conservative management. Following excision, histopathology confirmed the diagnosis. Seven days postoperatively, he developed spontaneous, painless bleeding from the left upper eyelid. Follow-up examination suggested a small pyogenic granuloma, which was excised, but recurrent hemorrhage persisted. Further hematologic workup was unremarkable. A short course of oral tranexamic acid was initiated, leading to complete resolution of bleeding within 24 hours. Delayed hemorrhage following chalazion excision is rare, with limited cases reported, and this case demonstrates successful noninvasive management with oral tranexamic acid. While tranexamic acid is widely used in major surgeries, its role in minor ophthalmic procedures remains off-label. This case supports its potential utility as a hemostatic agent in select ophthalmic cases, warranting further investigation into its efficacy and safety in this context.