A number of different lesions can present on the eyelid. The majority are harmless, and an accurate diagnosis can be made based on history and clinical examination. Eyelid lesions can be removed using a small local anaesthetic injection often with no need for sutures. It is important that any lesion removed is sent away for analysis to confirm the diagnosis. A variety of skin cancers can also present on the eyelid and being examined by an experienced oculoplastic surgeon will ensure that these are picked up at an early stage and treated appropriately.
Chalazion
A chalazion is a firm, round lump which can form in the upper or lower eyelid. It is caused by chronic inflammation or blockage in the oil glands within the eyelid. Chalazia are not usually painful, but may sometimes be tender, and they tend to last for a few weeks.
Very often a chalazion resolves without any intervention and gets better on its own after a few weeks. Some conservative home treatments can promote early resolution such as a warm compress to the eyelid for 10 to 15 minutes, twice a day, and gentle massage to the area to help soften and drain the blockages in the oil glands. If the chalazion persists after two months, it is unlikely to resolve on its own and you may need a minor procedure.
Persistent chalazia can be treated by surgical incision followed by curettage (drainage) of the inflammatory material under a local anaesthetic. This method of removal will leave no visible scarring on your eyelid.
Xanthelasma
Xanthelasma are soft, yellowish cholesterol deposits which usually appear on or around the inside corners of your eyelids. They are neither harmful nor painful however you may not like the way they look. Xanthelasma can be associated with high levels of cholesterol in your blood but they can also present even if your cholesterol levels are normal.
Xanthelasma will not go away on their own, and will either remain the same size or grow with time, but there are a number of treatment options available if you do not like the way they look.
Xanthelasma can be treated using various methods including the use of medicines, by cryotherapy (freezing the deposit with an extremely cold chemical), by laser surgery or by traditional surgical excision. Treatments for xanthelasma work well but they can sometimes result in scarring or changes in skin colour and these will be discussed fully with you by your consultant.
Basal cell carcinomas
Most eyelid lesions are not malignant but careful history taking and clinical examination will reveal important clues when it is suspected that a lesion is sinister.
A basal cell carcinoma (BCC) is the most prevalent malignant lesion in the eyelid and surrounding area. It most frequently presents in the lower eyelid or in the inner corner of the eyelid and is a firm, raised pearly lesion with fine blood vessels the surface. They may disrupt the normal appearance of the eyelid and lead to eyelashes being misdirected. BCCs are usually slow growing, persistent lesions. They are often painless, but they may bleed or ulcerate. They do not typically spread to other parts of the body.
If your consultant suspects a BCC, diagnosis is confirmed through a small biopsy. Once confirmed treatment will be recommended in the form of surgery to ensure all of the malignant tissue is removed. Depending on the size of the lesion, you may or may not require subsequent reconstructive surgery. With the eyelid being a delicate and complex functional structure, the specialist knowledge of an expert oculoplastic consultant will be required to ensure your eyelid is reconstructed in the correct way.