Incision and Curettage on a Left Upper Eyelid Chalazion

CHAPTER 1

Hello, my name is Dr. John Lee.I'm the oculoplasticand reconstructive surgeon for Boston Vision.I wanna describe to you a videoof a chalazion incision and curettage.Once a decision is made to proceed with an incision,the area of the lid is anesthetizedwith 2% lidocaine and epinephrine on a 32 gauge needle.Once the area is fully anesthetized,it is clamped with a chalazion clamp of appropriate size.The lid is then everted over that clamp,exposing the palpebral surface.That surface is then incised with a number 11 blade.A curette is then introduced through that incision siteand used to empty out the chalazion cavity.Once that's complete, the clamp is removedand the patient can be discharged.

CHAPTER 2

So we're gonna do an incisionand curettage on a left upper lid chalazion.She already has some lidocaineinfiltrated in this area,so should be quite comfortable.We always have some more medicationif you start feeling some pain.

CHAPTER 3

This chalazion clamp has a solid backside and an open front.We will put the open side posteriorly,put it over the chalazion and squeeze.So this is the part I told youyou're gonna be feeling a little pressure.It has a screw type lockon the clamp, feeling that pressure.And then we go ahead evert the lid.Who's taking a picture of that for me?It's all gonna be on video for us.

CHAPTER 4

Okay, this is a number 11 blade.Make an incision through the tarsal plate,and you can see the lipogranulomatous materialis starting to come out.

CHAPTER 5

And we have a small curette, through the incision...And you can start to see the lipogranulomatousmaterial coming out there.Are you having pain? No, just weirdness.Definitely weird. Just, just...Not an everyday experience, is it?What are you doing now?Not an everyday experience for you, is it?No.What's happening now?So I'm actually just scooping outall that stuff in there.Okay.It's coming out very nicely.Now, do you test that or not? No.And the idea is to take outthe entire cavity, scrape around.Occasionally you will feel some scar material.Oh, that hurt.Okay.

CHAPTER 6

Release the clamp, put the lidback into its position.

CHAPTER 7

And palpate around.I don't feel any nodule there anymore.I'll palpate from both sides to confirmthat it is indeed an empty cavity.It is.You are all done.So, right now the treatment is pressure.So I'm gonna go ahead and after the drape comes off,I'm gonna have you put your hand up thereand hold some pressure, and then we'll be all done.Okay.