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Conditions & Treatments

Eyelid Lesions and Growths

There are many types of eyelid lesions including inflammatory and infectious lesions, benign tumors and cancers. Most eyelid lesions are benign, but accurate diagnosis is essential to identify more suspicious lesions.

Eyelid Anatomy

The eyelid is made of skin and muscle and glands which secrete lubricating fluids that keep the eyes moist and form part of the tear film. The lids are lined with mucous membranes and bordered with eyelashes.

Inflammatory lesions

A chalazion is a painless, slow growing cystic lesion caused by inflammation of a blocked eyelid oil (meibomian) gland. It presents as a chronic localized swelling and redness of the lid with discomfort but usually not much pain. It is associated with rosacea and/or blepharitis (eyelid inflammation). A chalazion can be treated at home with warm compresses, and often goes away within days or weeks. If not, medication can help. If not improved, they can be removed with a minor in-office procedure.

A stye is an acute infection of a gland in the eyelid. It presents as a warm, red, swollen and painful, pus-filled pimple among the eyelashes. It can be treated at home with warm compresses that will help the pus drain. Washing with diluted baby shampoo to keep your eyelids clean can prevent a stye. If the infection spreads to the rest of the lid it will require antibiotics.

Infectious lesions

Molluscum is a lid lesion caused by a viral infection that is usually benign and mild. It is characterized by multiple, small, pale, waxy and nodular cysts on and around the eyelids. It is common in children under age 15, young adults and people with a compromised immune system. Eczema can develop around the lesions. It is contagious and can spread to other parts of the body. It can cause conjunctivitis. The condition is often self-limiting and may need to be treated if it persists.

Benign lesions

Xanthelasma is cholesterol deposits in the eyelids. It presents as multiple soft, yellowish plaques in the either the upper or lower eyelids and is commonly found in the elderly. It is associated with cholesterol metabolism but is not necessarily the result of high cholesterol, except in genetic hypercholesterolemia. It can be excised, frozen, or removed with a laser .

Epidermal inclusion cysts are benign slow growing tumors caused by over production of skin cells in the hair follicles of the eyelashes. They are commonly referred to as eyelid cysts and present as elevated, smooth and progressively growing cysts of trapped skin cells. They can become inflected or rupture. The treatment is simple excision.

Hidrocystoma is a fluid-filled cyst caused by a blocked sweat gland. It presents as a small, soft, transparent lesion along the margin of the eyelid and is commonly located near the nose. Preferred treatment is simple office-based excision.

Squamous cell papilloma (a skin tags) is a benign growth that forms from overproduction of skin cells and presents as flesh-colored finger-like projections that do not require removal except for cosmetic reasons. They can be excised, burned or frozen off.

Seborrheic keratoses are an acquired benign condition that causes greasy lesions that vary in color and can look like a wart. Excision can remove the lesions, but they tend to reoccur. They are common in elderly patients.

Premalignant Neoplastic Lesions

An actinic keratosis is a precancerous lesion that can be found on the eyelids and has a sandpaper like texture. They can be frozen off or treated with topical agents. If there is concern for malignancy, excisional biopsy will be recommended to establish a diagnosis.

Malignant tumors

Basal cell carcinoma is a tumor in the area around the eyes and is the most common cancer of the eyelids caused by sun exposure. It presents as firm, raised pearly nodules with fine blood vessels. It affects people middle aged and older. Early treatment may include Mohs surgery and repair with oculoplastics to help maintain normal appearance..

Squamous cell carcinoma is the second most common eyelid malignancy. It occurs most often in the lower lid and presents as a painless nodular lesion with irregular edges, blood vessels and central ulceration. It is invasive and can cause disfiguration. Surgery and repair with oculoplastics surgeons is a common treatment.

Sebaceous carcinoma is a rare cancer that develops in the meibomian (oil) glands of the eyelid, and presents as a yellowish discoloration, causes a loss of eyelashes and destroys the gland. It often follows a chronic eyelid inflammation and conjunctivitis. A biopsy makes the diagnosis. Treatment is by surgical excision. Radiation therapy may be needed.

Union Square Eye Care offers the most advanced therapies for eyelid lesions and growths.

Patients trust us to deliver comprehensive care by dedicated and compassionate experienced oculoplastic and orbital surgeon. When you have a concern, contact us to schedule a consultation for definitive diagnosis and treatment.

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