A hard lump in the eyelid may be a chalazion. It is a chronic granuloma that forms when the ducts of the lid gland become blocked and material secreted by the gland becomes trapped inside, irritating the surrounding tissue. The lumps are raised to the touch on the eyelids, are not obviously painful, are more visible when the eyelids are closed, and are mostly round. The corresponding conjunctival area of the eyelid may have limited congestion, often purplish or gray, and secondary bacterial infection may result in a red and painful eyelid. Smaller chalazia generally do not require treatment and can be warmed up to promote absorption and dissipation; larger chalazia generally require outpatient surgery to scrape them out. In middle-aged and older adults, chalazia may also require exclusion of lid cancer.