Examine preauricular nodes to help determine infection. No intraocular pathology should be found. Presence of fever or distant nodes is not consistent with a chalazion. No lab studies are indicated. Since chalazia are sterile inflammations, cultures are not necessary.
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.