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Clinical features, treatment outcomes, and risk factors for surgery in pediatric chalazion
Monica Samant1,2, Abhinav Mishra1,2, Sarita Deshpande3
1Department of Pediatric Ophthalmology & Strabismus, Laxmi Eye Hospital and Institute, Mumbai, Maharashtra, India.
Insights
Most pediatric chalazia resolve with conservative treatment within six weeks. Older age at presentation is the main predictor for needing surgery for chalazion in children.
Area of Science:
- Ophthalmology
- Pediatric Medicine
Background:
- Chalazion is a common eyelid condition in children.
- Understanding predictors for surgical intervention is crucial for effective management.
Purpose of the Study:
- To evaluate clinical presentation, treatment outcomes, and predictors of surgery in pediatric chalazion.
- Identify factors influencing the need for surgical intervention in children with chalazion.
Main Methods:
- Retrospective observational study of children (<18 years) with chalazion.
- Analysis of conservative treatment (hot fomentation, topical antibiotics) outcomes.
- Survival analysis and Cox regression to identify surgical risk factors.
Main Results:
- 91.8% of pediatric chalazia resolved conservatively within 6 weeks.
- Surgical intervention was required in 19% of cases.
- Increasing age at presentation independently predicted the need for surgery.
Conclusions:
- Conservative management is effective for most pediatric chalazia within 6 weeks.
- Age is a significant predictor for surgical intervention in pediatric chalazion.
- Further research into adjunctive therapies and systemic factors is warranted.
Purpose:
To evaluate the clinical presentation, treatment outcomes, and baseline predictors of surgical intervention in a large cohort with pediatric chalazion.
Methods:
This retrospective observational study included children (<18 years) diagnosed with chalazion between January 2017 and December 2024 with a minimum follow-up of 21 days. Initial treatment consisted of hot fomentation and topical antibiotics. Clinical resolution was defined as complete disappearance of the lesion without the need for surgery. Survival analysis and Cox regression models were used to identify risk factors for surgery.
Results:
A total of 471 eyes from 470 children were included (median age: 6 years). Of the 414 eyes initially managed conservatively, 380 eyes (91.8%) resolved without surgery within the first 6 weeks. Surgical intervention was required in 90 eyes (19%), including 56 advised at baseline. Kaplan-Meier analysis showed that among those requiring surgery, most underwent the procedure within 60 days of presentation (cumulative risk at 2 months = 23%; 95% CI: 17-29%). Children who underwent surgery were significantly older (9.7 ± 4.9 vs. 6.9 + 4.4 years, P < 0.001) and had longer symptom duration (median 60 vs. 30 days, P < 0.001) at baseline. In multivariable Cox regression, only increasing age independently predicted surgery (HR: 1.10; 95% CI: 1.04-1.17; P = 0.0002).
Conclusion:
Most pediatric chalazia resolve within 6 weeks of conservative treatment. Increasing age at presentation was the strongest predictor of surgical intervention. These findings support a time-bound approach to conservative management and highlight the need for prospective studies exploring adjunctive therapies and systemic risk factors.
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