No lab studies are indicated. Since chalazia are sterile inflammations, cultures are not necessary. Defer steroid injections and surgical drainage to an ophthalmologist or plastic surgeon. Ophthalmology texts indicate that topical or systemic antibiotics are not necessary. Although most ophthalmologists and ED texts still recommend topical antibiotic cream, tetracycline for a chronic chalazion also has been recommended.
Steroids stop inflammation and frequently cause regression of the chalazion within a few weeks.
A second injection may be necessary. Complications of steroid injections include hypopigmentation, atrophy of the area, and potential infection. If necessary, make a vertical incision in the palpebral conjunctival surface. For small chalazia, perform curettage of the inflammatory granuloma in the lid. For larger chalazia, dissect the granuloma for complete removal.