Chalazion rate highest among Hispanic/Latino, American Indian, Asian children
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Among children of all racial and ethnic groups, Hispanic/Latino, American Indian and Asian children developed chalazion at a higher rate, and those with meibomian gland disease or blepharitis were more likely to develop chalazia on multiple occasions.
“Identifying those at higher risk of chalazion formation, recurrent chalazion and chalazion requiring surgery (often including general anesthesia in children) can inform medical decision making,” Jacob Evans, MD, and colleagues wrote.
Evans and colleagues reviewed data from 28,433 patients aged 18 years or younger who visited ophthalmology and optometry departments between 2012 and 2019, focusing on 584 participants (2%; 63% girls) diagnosed with chalazia. The researchers noted demographics, number of chalazia in each location and chalazia treatments.
Chalazia were present in 1,088, 54% had blepharitis, 56% had meibomian gland dysfunction (MGD) and 4% had staphylococcal marginal keratitis. First incidence of chalazion occurred most often between ages 2 years to 5 years, with 255 participants (43.6%) presenting between those ages.
Hispanic/Latino children were more frequently diagnosed with chalazion than non-Hispanic/Latino children (3.8% vs 1.8%). White participants had the lowest percentage of chalazion diagnosis: 1.7% had chalazion, compared with 4.3% of American Indian or Alaska Native children and 4% of Asian children.
No statistically significant differences appeared between races or ethnicities in surgical intervention, multiple chalazia occurrence or number of children who developed chalazion on separate occasions.
Multiple chalazia developed in 55.6% of participants with MGD, blepharitis or staphylococcal marginal keratitis; 31.2% of those without these comorbidities had multiple chalazia. Separate occasions of chalazia appeared in 33% of those with ocular comorbidities and 17% of those without. There was no statistically significant correlation between ocular disease and surgery rate.
Study limitations included generalizability, which could be addressed in the future by large multicenter studies, and retrospective nature.
Evans and colleagues suggested that long-term eyelid hygiene may be able to treat or prevent chalazion, as well as eliminate the future need for surgery.
Perspective
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This study provides interesting insight into risk factors for chalazion, a condition commonly seen in both adult and pediatric patients. Although this study was only performed within one department of ophthalmology/optometry, the published data can give us valuable information on the presentation and management of patients with chalazion, including the association between race, ethnicity and underlying lid disease on the development of chalazion. The link between underlying lid disease, such as MGD and blepharitis, and the development of multiple chalazion emphasize the need for continued lid hygiene management in patients who present with chalazion to potentially prevent additional occurrences of this condition. This study found that despite the link between race, ethnicity and lid disease and the formation of chalazion, there was no significant correlation between these factors and the need for surgical intervention for chalazion. This information is important both for clinicians treating this condition and for patient education when beginning medical management of chalazion.
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