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Eyelid Lumps, Bumps and Cancers


Introduction
By far the most common lesion of the eyelid is a chalazion. However, it is important that a qualified doctor sees the lump to make a proper diagnosis because:
-Some lumps may require surgery, e.g. Basal Cell Carcinoma. If this is the case, the earlier surgery is performed, the less disfiguring it is likely to be.
-Some lumps may be sight or even life threatening e.g. sebaceous gland carcinoma, and prompt treatment may have an effect on improving the patient’s prognosis
-Some lumps may indicate a generalised illness. For example Xanthelasma may indicate dangerously high cholesterol levels.
-Some lumps may impair vision. Impairment of vision in young children may lead to poor development of vision and long term vision problems.

Eyelid Cysts, Styes, Chalazia, Benign Eyelid Lumps (and Powks)


Chalazion
Within the tough cartilage like structure of the back half of the eyelid (known as the tarsal plate) are numerous meibomian glands whose job is to secrete a fine oily secretion on to the surface of the eye to help lubricate it. Sometimes the duct of a gland can become blocked leading to retention of the oil secretion within the gland. The gland enlarges and becomes tender as it becomes inflamed. The patient complains of a red, tender lump of the eyelid. A chalazion (meibomian cyst, internal hordeolum) represents an inflammatory reaction against the retained oil secretion, (mebum) of the meibomian glands. Eventually the inflammation settles resulting in a painless hard lump. The patient may notice blurring of vision if the lump is particularly large causing distortion in the normal shape of the cornea.
The vast majority of chalazia will settle down by themselves and hot compresses, using a towel soaked in hot water, often aids this. Persistent chalazia can be removed with a simple operation where a small cut is made in the enlarged gland through the back surface of the eyelid and the retained oil secretions are removed.
Chalazia which develop repeatedly may result from chronic inflammation of the meibomian glands (blepharitis). However, chalazia which develop repeatedly in the same area of the eyelid despite surgery to remove them may signify something more sinister e.g. sebaceous gland carcinoma.

Chalazion viewed from the front. Notice the lump within the eyelid with overlying rednessSame chalazion seen from the inside of the eyelid

Click here for patient handout on why Chalazia develop and what can be done about it (Meibomian gland dysfunction and Chalazia)

Stye
A left lower lid stye. This is due to a blocked oil producing gland of the eyelid skin.
Although the terms chalazion, stye and cyst are often used interchangeably even by doctors to describe the same thing-i.e. some sort of cyst of the eyelid; the term stye actually describes an infection of the follicle of the eyelash. The patient often complains of red tender swelling of the margin of the eyelid. More commonly, styes have a small yellow head of pus. Like chalazia, hot compresses can help their resolution. Uncommonly, persistent styes may require surgery which consists of a simple incision into the stye itself under local anaesthesia.


Other Cysts of the eyelid
The skin of the eyelid contains sweat secreting glands and oil secreting glands. Blockage of the ducts of the glands leads to retention of the secretion and the development of cyst. Retained sweat secretions causes a clear fluid filled cyst of Moll, whereas retained oil secretion leads to a yellow fluid filled cyst of Zeiss.
These cysts are not dangerous and only require removal if they represent a cosmetic issue.

Click here for more photos of benign eyelid lumps

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