Halyazion – the good-quality opukholevidny consolidation (hailstone) in the thickness of a century developing against the background of obstruction and a chronic inflammation of meybomiyevy gland. Halyazion is shown by existence of a small knot and swelling during a century, pressure upon an eyeball, irritation of covers of an eye, sometimes – suppuration and spontaneous opening. Diagnostics of a halyazion usually does not demand carrying out additional tool researches and is based on external examination of a century. Treatment of a halyazion can be conservative (instillations of medicines, a mortgaging of ointments, injections in education) or surgical (removal of a halyazion).
Halyazion (from Greek - a small knot, a gradinka) is characterized by the chronic proliferative inflammation of a century around meybomiyevy gland developing at obstruction of its output channel and a congestion of a secret in it. Meybomiyev of gland are located in the thickness of a cartilage, have a tubular structure and open the output channels on an internal surface of a century. In every century there are about 50-70 glands which develop an external (lipidic) layer of a plaintive film. Function of meybomiyevy glands consists in preservation of moisture content of an eyeball and prevention of evaporation of a tear from the surface of an eye.
In ophthalmology is a widespread problem and makes a century of 7,4% in the general structure of pathology. The disease can affect people of all age, however meets among adult persons, mainly at the age of 30-50 years more often.
Reasons of a halyazion
As the reason of development of a halyazion serves obstruction of a channel of meybomiyevy (grease) gland of a century as a result of which the formed lipidic secret has no outflow outside and accumulates in a gleam of a channel of gland. This mechanism leads to an inflammation of fabrics around gland, encapsulation of the center and to formation of good-quality nodular consolidation during a century.
Quite often formation of a halyazion happens against the background of the previous barley, especially in cases of incomplete treatment or a recurrence of the last. Chronic contributes to development of a halyazion blefarit, a rozatsea, fat skin, seborrhea, diabetes, gastrointestinal diseases (dysbacteriosis, dyskinesia of biliary tract, chronic gastritis, enterokolit).
As the promoting factors stresses, overcoolings, a SARS, hypovitaminoses, hit of an infection in an eye at violations of the rules of personal hygiene, the incorrect address with contact lenses can act.
Microscopically it is formed by granulyatsionny fabric and a large number of epitelioidny and huge cages.
Symptoms of a halyazion
At development of a halyazion under skin of the lower or upper eyelid dense roundish education appears. This small knot is located in the thickness of a cartilage, not soldered to skin, painless at a palpation. Education is inclined to slow increase and can reach the size of 5-6 mm. In process of increase it becomes noticeable from skin, forming a swelling and visible cosmetic defect. From a conjunctiva at survey the site of local hyperaemia with the central area of grayish color comes to light. Formation of several halyazion at the same time on the upper and lower eyelid is possible.
In certain cases is followed by an itch and dacryagogue, hypersensibility to a touch. Growing can press on a cornea, causing an astigmatism and distortion of sight. Not opened , existing a long time, turns into a cyst with mucous contents.
At suppuration of a halyazion inflammation symptoms appear: local reddening of skin, hypostasis, the pulsing pain, a small knot softening. Rise in body temperature and development of a blefarit is possible. Halyazion can spontaneously be opened on a conjunctiva surface with allocation of a purulent secret. At the same time the course around which granulations expand is formed svishchevy. Skin becomes a century the dry, reddened, covered dried-up crusts separated.
Diagnostics of a halyazion
Recognition of a halyazion is made by the ophthalmologist at external examination of a modified century. Are the main signs of education identification of the consolidation in the thickness of a century of the size of prosyany grain or a small pea which is not soldered to surrounding fabrics. At a reversing of a century local hyperaemia of a conjunctiva is noted. At the movement the affected eyelid lags behind from healthy makes the blink movements less often.
Performing tool diagnostics at the halyaziyena, as a rule, is not required. Recidivous and fast-growing halyaziona demand differential diagnostics with an adenocarcinoma of meybomiyevy gland. For this purpose carrying out a histologic research of a bioptat of education can be required.
Treatment of a halyazion
At early stages of a halyazion conservative methods are applied. Instillations of disinfecting eye drops, a mortgaging for an eyelid of mercury ointment are appointed. For treatment of a halyazion dry thermal compresses, UVCh-therapy, massage of a century and the corked gland can be used. As a contraindication to holding thermal procedures serves the inflammation of a halyazion as warming up can promote distribution of an inflammation on nearby fabrics with development of abscess or phlegmon of a century.
Good medical effect injections in kortikosteroidny medicines (a beta metazone, a triamtsinolona) have. Corticosteroids are entered into a cavity of a halyazion by a thin needle and lead to a gradual rassasyvaniye of a new growth.
Radical treatment of a halyazion is carried out by a surgical way. Operation has out-patient character, is carried out under local anesthesia through a transconjunctival or skin section. During operation vylushchivat together with the capsule. At formation of the svishchevy course the operational section is carried out on all its length then the changed fabrics are excised. After removal of a halyazion on an eyelid impose seams, and approximately - the hard pressing bandage. In the postoperative period within 5-7 days application of anti-inflammatory eye drops or ointments is recommended.
As alternative to a classical surgical method serves laser removal of a halyazion. In this case the capsule section by the laser, removal of contents of a halyazion with the subsequent evaporation of the capsule laser radiation is made. Laser removal of a halyazion is less traumatic, does not demand suture and allows to exclude a disease recurrence. For the warning of traumatizing a cornea a postoperative hem within several days to the patient recommend to carry a soft contact lens.
Forecast and prevention of a halyazion
The current of a halyazion can be complicated by an abstsedirovaniye and formation of phlegmon of a century. After incomplete removal of the capsule of a halyazion the disease recurrence is possible.
Prevention of development of a halyazion requires carrying out full volume of treatment of a meybomiit, blefarit, observance of requirements of hygiene when using contact lenses, increase in the general reactivity of an organism.