What is your approach to intralesional steroid injection for chalazia (in terms of dosage, approach, timing)?

I offer the option of intralesional steroid to all patients with chalazia, particularly if there is significant inflammation present. I give up to 1 cc of a 10 mg/mL solution of dexamethasone. I have approached this by both transconjunctival as well as transcutaneous. I think transconjunctival hurts...

I am wholly unimpressed by the efficacy and usefulness of intralesional steroids for chalazia. Not even to mention the risk of skin thinning and hypopigmentation in darker-skinned patients. Warm compresses work the best then surgical excision. This is an alternative that should be left on the shelf,...

Risk of complications and poor results do not justify the procedure; I don't do it.