A small bump under the eye that is not painful, itchy, or red is most often considered a cyst of the lid gland. A cyst in the lid gland is a blockage in the opening of the lid gland that causes secretions to accumulate in the lid ducts and form a cyst, also known as a chalazion. Small chalazia can slowly go down on their own with conservative treatment by applying heat. However, some chalazia do not improve significantly even with hot compresses, but instead grow larger or are initially found to be large, often because they have formed a cyst wall in the duct lumen that prevents the body from absorbing the secretions. In this case, surgical excision is required to completely eliminate the cyst. The surgical removal is usually done on the conjunctival surface and usually does not cause much scarring and does not affect the aesthetics too much.