Resolution of recurrent chalazion using LLLT

Recurrent chalazia present a challenge in clinical practice. Photobiomodulation is a novel approach to management, which, as described in this patient case, can offer encouraging results.

A 42-year-old Asian female presented with a history of recurrent chalazia spanning several years. She had previously undergone multiple incision and curettage (I/C) procedures and had been using warm compresses and topical treatments with limited success. Her medical history included breast cancer and she was undergoing treatment with tamoxifen at the time of presentation.

Despite a course of Maxitrol (neomycin, polymyxin B and dexamethasone) and oral azithromycin, her most recent chalazion remained unresolved. She underwent four sessions of intense pulsed light (IPL) therapy between September and October 2024, which led to partial symptom improvement but did not fully resolve the lesion.

Subsequently, two sessions of low-level light therapy (LLLT) were administered. Following treatment, the patient reported significant symptom relief and complete resolution of the chalazion. Meibomian gland expression improved notably from thick, toothpaste-like secretions to a more fluid, higher-volume output.

Clinical reflections

This case highlights the potential of LLLT as an adjunctive treatment for patients with chronic meibomian gland dysfunction and chalazia, particularly when conventional therapies have had limited efficacy. In our experience, LLLT appears to support gland function and reduce inflammation, contributing to symptom resolution.

LLLT is a form of photobiomodulation which uses specific wavelengths of light to stimulate cellular metabolism and modulate inflammatory pathways. The light energy is absorbed by mitochondrial chromophores, leading to increased ATP production and activation of cellular signalling cascades. While its use is well-established in dermatology and dentistry, ophthalmic applications are still emerging.

LLLT can be used as a standalone therapy or in combination with IPL. It is usually administered over a series of two to four sessions, with one to two weeks between treatments. The device comprises a mask worn over the upper portion of the face that emits light of specific wavelengths to deliver the desired treatment effect over a 15-minute session. Red light is used for treating meibomian gland dysfunction, evaporative dry eye and chalazia. Blue light is used for anterior blepharitis and rosacea.

Conclusion

Warm compresses and topical/oral medical therapy are common first-line chalazia treatments, though may not lead to complete resolution. Surgical intervention with I/C is often successful but leads to permanent destruction of meibomian glands. LLLT is proving to be a valuable non-invasive addition to our clinical toolkit.

Over the past 12 months, we’ve integrated the Eye-Light IPL/LLLT system into our clinical practice and have observed consistently positive outcomes in patients with refractory symptoms. We’ve seen improvements in meibomian gland function, reduction in inflammation and enhanced patient comfort, often in individuals who had exhausted conventional treatment options.

While further research is needed to establish long-term efficacy and refine treatment protocols, our experience suggests LLLT is beneficial in the therapeutic arsenal for dry eye and lid disease. It offers a non-invasive, well-tolerated option which can complement existing therapies and improve quality of life for selected patients.

Catherine Wong and Sang Hoo Lee are optometrists at Eye Institute Remuera, where LLLT is integrated into a comprehensive approach to dry-eye management. Wong is the clinical team lead, bringing leadership and extensive experience in therapeutic optometry. Lee holds a clinical master’s degree in dry eye and has clinical expertise working across glaucoma, refractive laser, cataract and ocular surface clinics.