Twenty years of chalazion, big data analysis

To describe large-scale epidemiological patterns of chalazia and assess treatment outcomes.

We conducted a retrospective cohort study using the Clalit Health Services electronic medical record database, analyzing demographic data, medical history, treatments, procedures, and outcomes between January 2003 and December 2022.

A total of 611,993 chalazion diagnoses were recorded in 412,365 patients. Invasive procedures were required in 56,840 cases (9.3%). After topical therapy, 11.2% of cases progressed to surgical management (18.3% with neomycin/polymyxin-B/dexamethasone, 9.7% with chloramphenicol, 13.9% with tobramycin, and 7.1% with azithromycin). Those treated only with lubricants required intervention in 6.0% of cases. Differences across treatments were statistically significant (p < 0.01). Invasive intervention was age-dependent: 1.8% in patients <18 years, 8.1% in those 18-45, and 13.7% in those> 45 (p < 0.0001). Chalazion incidence correlated strongly with mean monthly temperature (r = 0.71, p < 0.001), with higher prevalence above 21°C (specificity 0.91, sensitivity 0.79, AUC 0.90).

Most chalazia resolve with conservative management. Age and climate significantly influence both incidence and treatment outcomes. These findings underscore the role of environmental and demographic factors in a chalazion's clinical course and may guide more tailored management strategies.