Eyelid and periorbital lesions encompass a wide range of etiologies and clinical presentations, often posing diagnostic challenges. We report a case of a right lower eyelid mass that was initially referred to as a nonresolving chalazion. Clinical suspicion suggested a vascular lesion; however, magnetic resonance imaging indicated a dermoid or epidermoid cyst. Definitive diagnosis was achieved through histopathological examination of the excised specimen, which revealed a vascular thrombus originating from a true aneurysm of an artery. In the absence of a clear history of trauma, infection, or a systemic illness, an unrecognized injury was considered the most plausible explanation. To the best of our knowledge, a vascular thrombus arising from a true arterial aneurysm involving the lower eyelid has not been previously reported. This case report underscores the importance of comprehensive clinical, radiological, and histopathological evaluation in the assessment of atypical eyelid lesions.

To highlight a rare case of eyelid schwannoma in a teenager, clinically mimicking a common chalazion, and confirmed by histopathology and immunohistochemistry. A 15-year-old boy presented with a slowly enlarging, painless right lower eyelid nodule. Initially diagnosed as a chalazion or sebaceous cyst, the lesion was surgically excised. Histopathological examination revealed interwoven fascicles of spindle cells with Antoni A and B patterns and Verocay bodies. Immunohistochemistry revealed strong S-100 protein positivity, confirming the diagnosis of schwannoma. Eyelid schwannomas are extremely rare and often mimic benign lesions such as chalazia. An accurate diagnosis requires histopathological and immunohistochemical evaluations. This case underscores the importance of considering nerve sheath tumors in the differential diagnosis of persistent eyelid swelling.

Hordeolum is usually self-limited, but a subset of patients develop persistent, symptomatic induration or prefer to avoid incision and curettage in the cosmetically sensitive eyelid. Currently, treatment methods for hordeolum mainly include local warm compresses, local or systemic antibiotic therapy, and abscess incision and drainage. We describe a small case series of 4 female patients with eyelid inflammatory nodules within the hordeolum-chalazion spectrum treated with local injection of 6-fold diluted 5-fluorouracil. Clinical response and adverse events were recorded. Two patients achieved complete clinical resolution within 3 to 7 days after a single injection. One bilateral case improved rapidly after the initial injection; the right-sided lesion resolved by day 7, whereas a left-sided induration persisted despite a second injection and remained essentially unchanged at follow-up. One long-standing post-incision-and-drainage case showed marked reduction by day 2 and further improvement by day 7 but did not completely resolve. No treatment-related adverse events were observed, and no recurrence was noted in cases with complete resolution during follow-up. Local injection of 6-fold diluted 5-fluorouracil may represent a potential minimally invasive option for selected patients with persistent eyelid inflammatory nodules. Responses were variable in this small uncontrolled series; further controlled studies are warranted to clarify efficacy, optimal dosing, and safety.

An intralesional triamcinolone acetonide injection is one of the treatment options for chalazia. However, lesions clinically resembling chalazia may occasionally represent other pathological entities, potentially leading to unexpected complications after treatment. We report the case of a 54-year-old man with a left upper eyelid mass initially diagnosed as a chalazion and treated with an intralesional triamcinolone acetonide injection. The following day, the lesion showed marked worsening, with swelling, redness, and pain. Imaging revealed a cystic lesion, and bacterial infection could not be excluded. Intravenous antibiotics were initiated; however, the lesion continued to worsen, and drainage yielded sterile purulent material. Surgical excision revealed a cystic lesion containing keratinous material. Histopathological examination demonstrated marked inflammatory cell infiltration without granulomatous inflammation or lipid-laden macrophages characteristic of chalazion. Based on the surgical findings, histopathological findings, and clinical course, the lesion was diagnosed as an intratarsal keratinous cyst complicated by rupture and foreign body inflammatory reaction following intralesional steroid injection. This case highlights the importance of careful differential diagnosis in eyelid lesions mimicking chalazia. An intralesional steroid injection may cause severe inflammatory complications when administered to inappropriate lesions.

Anterior segment eye diseases significantly affect patients' quality of life (QoL) by impairing physical health, psychological well-being, social interactions, and economic stability. Conditions such as dry eye disease, blepharitis, conjunctivitis, keratoconus, keratitis, and corneal dystrophies cause chronic discomfort, visual disturbance, and emotional distress, leading to reduced daily functioning and work productivity. Other disorders like chalazion, trichiasis, ptosis, strabismus, and thyroid eye disease entail a psychological burden by affecting appearance and social confidence. This narrative review comprehensively examines the multidimensional impact of anterior segment diseases on QoL. A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar for English-language articles published between December 1997 and February 2025. Using relevant keywords and Boolean operators, we initially identified 854 articles. Following duplicate removal and screening based on inclusion and exclusion criteria focused on QoL-related outcomes in anterior segment diseases, we selected 72 high-quality studies for the review. This methodology ensured a thorough and focused analysis of the available evidence. Findings highlight the importance of addressing both clinical symptoms and psychosocial effects in management strategies. Future research should emphasize interventions that improve ocular function alongside overall well-being.