# Chalazion (meibomian cyst) - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: AAO Chalazion Preferred Practice Pattern · DailyMed Tobramycin Ophthalmic Solution 0.3% Package Insert (or UK eMC Tobrex 0.3% Drops SmPC) - Verified date: 2026-08 ## Verified against - DailyMed Tobramycin Ophthalmic Solution 0.3% Package Insert (or UK eMC Tobrex 0.3% Drops SmPC) - Chalazion - disease-level clinical article (chalazion-clinical.txt) ## Treatment metadata - Tobramycin — eye - Referral & safety-netting (no drug therapy) - Doxycycline — oral.solid ## Complete treatment card ```text CHALAZION (MEIBOMIAN CYST) Sources: AAO Chalazion Preferred Practice Pattern · DailyMed Tobramycin Ophthalmic Solution 0.3% Package Insert (or UK eMC Tobrex 0.3% Drops SmPC) Review status: REVIEWED against DailyMed Tobramycin Ophthalmic Solution 0.3% Package Insert (or UK eMC Tobrex 0.3% Drops SmPC), Chalazion - disease-level clinical article (chalazion-clinical.txt) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (4) - A chalazion typically appears as a painless eyelid lump present for weeks to months before presentation - It can impair vision, cause discomfort, or turn inflamed, painful or secondarily infected - A history of prior similar lesions is common since chalazia recur in predisposed people - Acute vision change, pain recurring at the same site, fever, limited eye movement or diffuse facial swelling point elsewhere [facial swelling · fever] SIGNS - what you find (3) - A palpable, usually non-tender, non-fluctuant nodule under 1 cm, most often on the upper lid, is typical - Chalazia sit deeper in the lid than a hordeolum, which is tender, superficial and centered on a lash - Everting the lid is part of the exam, done to look for an internal chalazion TESTS (1) - Diagnosis is usually clinical, with no further workup needed unless another diagnosis is suspected, in which case biopsy is considered IF NOT THIS - what else fits (4) - Sebaceous, basal cell or squamous cell carcinoma must be excluded by biopsy when there is clinical concern - Infectious mimics include blepharitis, dacryocystitis, herpes zoster or simplex, molluscum contagiosum, leishmaniasis and cellulitis - Benign mimics to weigh include papillomas, hordeolum, juvenile xanthogranuloma and xanthelasma - Tuberculosis and leishmaniasis have been reported as mistaken for a chalazion in patients from endemic regions Source StatPearls "Chalazion" - disease-level clinical article Status traced to the source above 1. TOBRAMYCIN [1st line] Adult In mild to moderate disease, instill one or two drops into the affected eye(s) every four hours. Peds Children aged 2 months and over: the same regimen as adults - one or two drops into the affected eye(s) every four hours in mild to moderate disease. The label gives a single dosing regimen and does not separate adults from children, and states: "Clinical studies have shown tobramycin to be safe and effective for use in children." Below 2 months it states: "Safety and effectiveness in pediatric patients below the age of 2 months has not been established." Source Tobramycin Ophthalmic Solution USP 0.3%, DOSAGE AND ADMINISTRATION (DailyMed SetID 3c23234a-452b-40d0-922f-37e49147d537, Alembic Pharmaceuticals): "In mild to moderate disease, instill 1 or 2 drops into the affected eye(s) every 4 hours. In severe infections, instill 2 drops into the eye(s) hourly until improvement, following which treatment should be reduced prior to discontinuation." The same label sets no separate paediatric dose - see peds_note. Why Indicated only if secondary bacterial infection is present; primary chalazion is a sterile granuloma managed with warm compresses. Caution Mainstay of therapy is daily warm compresses and massage towards lid margin; topical antibiotics do not penetrate non-infected granulomas. Refer to ophthalmologist for incision and curettage if persistent >6-8 weeks or causing astigmatism. Egypt SWIXTOBRAM 0.3% EYE DROPS 5 ML CHEMIPHARM 6.50 EGP T GRAND 0.3% EYE DROPS 5 ML DELTA GRAND P... 7.00 EGP TOBRAL 0.3% EYE DROPS 5 ML KAHIRA 7.00 EGP TOBRACTIVA 0.3% EYE DROPS 5 ML EPCI 18.00 EGP AVAZIR 0.3% EYE DROPS 10 ML ORCHIDIA PHAR... 28.00 EGP TOBREX 0.3% EYE DROPS 5 ML NOVARTIS > NO... 32.50 EGP TOBRIN 0.3% EYE.OINT. 5 GM EIPICO 23.00 EGP AVAZIR 0.3% EYE OINT. 5 GM ORCHIDIA PHAR... 26.00 EGP 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Chalazion - disease-level clinical article (chalazion-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Biopsy is required for recurrent chalazia to rule out sebaceous cell carcinoma. 3. DOXYCYCLINE [2nd line] Adult 100 mg by mouth twice daily x 10 days Peds 2.2 mg/kg/dose [child max 100 mg] (Children and Adolescents: Oral, IV: 2.2 mg/kg/dose every 12 hours, maximum dose: 100 mg/dose.) 3kg -> 6.6 mg/dose 4kg -> 8.8 mg/dose 5kg -> 11 mg/dose 6kg -> 13.2 mg/dose 7kg -> 15.4 mg/dose 8kg -> 17.6 mg/dose 9kg -> 19.8 mg/dose 10kg -> 22 mg/dose 11kg -> 24.2 mg/dose 12kg -> 26.4 mg/dose 13kg -> 28.6 mg/dose 14kg -> 30.8 mg/dose 15kg -> 33 mg/dose 16kg -> 35.2 mg/dose 17kg -> 37.4 mg/dose 18kg -> 39.6 mg/dose 19kg -> 41.8 mg/dose 20kg -> 44 mg/dose 21kg -> 46.2 mg/dose 22kg -> 48.4 mg/dose 23kg -> 50.6 mg/dose 24kg -> 52.8 mg/dose 25kg -> 55 mg/dose 26kg -> 57.2 mg/dose 27kg -> 59.4 mg/dose 28kg -> 61.6 mg/dose 29kg -> 63.8 mg/dose 30kg -> 66 mg/dose 31kg -> 68.2 mg/dose 32kg -> 70.4 mg/dose 33kg -> 72.6 mg/dose 34kg -> 74.8 mg/dose 35kg -> 77 mg/dose 36kg -> 79.2 mg/dose 37kg -> 81.4 mg/dose 38kg -> 83.6 mg/dose 39kg -> 85.8 mg/dose 40kg -> 88 mg/dose 41kg -> 90.2 mg/dose 42kg -> 92.4 mg/dose 43kg -> 94.6 mg/dose 44kg -> 96.8 mg/dose 45kg -> 99 mg/dose 46kg -> 100 mg/dose (capped) 47kg -> 100 mg/dose (capped) 48kg -> 100 mg/dose (capped) 49kg -> 100 mg/dose (capped) 50kg -> 100 mg/dose (capped) Source Chalazion (meibomian cyst) - disease-level clinical article (chalazion-clinical.txt) Why Oral tetracycline antibiotic when secondary infection or blepharitis is associated with a chalazion. Caution Contraindicated in pregnancy and children <8 years (permanent dental staining and bone growth inhibition). Doxycycline 100 mg Capsules SmPC says, in section 4.2, "Doxycycline should not be used in children aged younger than 8 years due to the risk of teeth discolouration", in section 4.3, "Doxycycline is contraindicated in pregnancy", and in section 4.4 that tetracyclines used during tooth development "may cause permanent discolouration of the teeth (yellow-grey-brown)" and that "Enamel hypoplasia has also been reported". Photosensitivity reaction; instruct patient to use broad-spectrum sun protection. Take with full glass of water while standing to avoid esophageal ulceration. Egypt FARCODOXIN 100MG 10 CAPS. PHARCO 11.00 EGP (1.10/unit) DOXY M.R.100 MG 10 CAPS. ADWIA 12.00 EGP (1.20/unit) GRANUDOXY 100MG 10 F.C. TAB. GLOBAL NAPI P... 12.00 EGP (1.20/unit) DOXYDOX 100 MG 10 CAPS. EIPICO 23.00 EGP (2.30/unit) DOXYMYCIN 100 MG 10 CAPS. EL NILE. 30.00 EGP (3.00/unit) DOXYCOST 200MG 10 TABS. PENTA PHARMA 43.00 EGP (4.30/unit) TABOCINE 100MG 10 CAPS. TABUK PHARMAC... 46.00 EGP (4.60/unit) VIBRAMYCIN 100MG 10 CAPS. PFIZER 65.00 EGP (6.50/unit) Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)