Children that present with chalazions should not be routinely referred into Paediatric Ophthalmology as they generally spontaneously resolve.
Topical antibiotics do not have any effect on the cyst itself. If there is erythema around the cyst, please prescribe systemic antibiotics.
Resolution can be encouraged by a series of lid massage, hot compresses and lid hygiene. If the cysts do not spontaneously resolve please refer after 3 months have lapsed and the above measures have not helped.
Prevention of recurrent cysts can be aided by an Eyebag, or Meibo patch and lash toilette. Azithromycin 1.5% eye drops is sometimes used for 3 days in every week for 6 weeks and can help control significant blepharitis which causes cysts. However, this product is not licenced for this diagnosis.
Dermoid cysts should be referred as they will need surgical intervention and the earlier the intervention the easier to treat.
The differentiation between chalzions/meibomium cyst and dermoids is that the former are found within the substance of the eyelid whilst dermoids are found on the bone, particularly where bony plates join such as the frontal bone and maxilla or the ethmoids and frontal bones.