What are eyelid lesions?
An eyelid lesion is any abnormal growth, bump, or change in tissue that develops on or along the eyelid. Eyelid lesions are common and vary widely in appearance, cause, and clinical significance, ranging from harmless benign eyelid lesions to growths that require prompt medical evaluation.
Because the eyelids are thin, delicate structures in close proximity to the eye, any growth that changes in size, appearance, or behavior warrants professional assessment.
What are the symptoms of an eyelid lesion?
Symptoms vary depending on the type and cause of the lesion. Common signs that prompt evaluation include:
- A visible lump, bump, or growth on the upper or lower eyelid
- Redness, swelling, or tenderness around the affected area
- A lesion that is growing, changing color, or changing shape
- Crusting, bleeding, or ulceration of a growth
- Loss of eyelashes in the area of the lesion
- A feeling that something is in the eye
What causes eyelid lesions?
Eyelid lesions develop for a variety of reasons depending on the type of growth involved:
- Gland blockage or infection – Growths can arise when eyelid glands become obstructed or infected.
- Chronic sun exposure – Ultraviolet radiation is the primary driver of most eyelid skin cancers and contributes to a range of benign changes in eyelid skin over time.
- Age-related skin changes – Many benign lesions become more common as skin loses elasticity and regenerates more slowly with age.
- Viral or bacterial infection – HPV is associated with certain benign eyelid growths, while bacterial infections are responsible for styes.
How are eyelid lesions diagnosed?
Eyelid lesion evaluation begins with a thorough clinical examination. An oculofacial plastic surgeon will assess the size, shape, color, texture, and location of the growth, as well as any changes the patient has noticed over time. The eyelid margin, lash line, and surrounding tissue will be carefully examined for signs that suggest a lesion may be malignant.
In many cases, a diagnosis can be made based on clinical appearance alone. When the nature of a lesion is uncertain, a biopsy is recommended. A biopsy involves removing a small sample of tissue for examination under a microscope, which provides a definitive diagnosis and guides treatment planning.
How are eyelid lesions treated?
Treatment of eyelid lesions depends on the type, size, and location of the lesion, as well as whether it is causing functional symptoms or concern for malignancy.
In benign cases, observation, warm compresses, and lid hygiene are recommended as a first-line approach. Eyelid lesion removal is recommended for benign growths that are enlarging, causing irritation, affecting eyelid function, or are a cosmetic concern. Removal is typically performed in-office under local anesthesia with minimal recovery.
Excisional biopsy is performed when a lesion cannot be definitively diagnosed on clinical appearance alone or when malignancy cannot be ruled out. The removed tissue is sent for pathological analysis.
If the biopsy confirms that the eyelid lesion is malignant, Mohs microsopic surgery followed by reconstruction is the standard of care. Mohs surgery removes the cancer in precise layers while preserving as much healthy tissue as possible. Once clear margins are confirmed, an eyelid defect repair is performed to restore both function and appearance.
Recovery following eyelid lesion removal depends on the extent of the procedure. Minor removals typically involve minimal downtime. More complex excisions or reconstructive procedures may require one to two weeks of recovery, with swelling and bruising resolving gradually over that period.
A lump or growth on the eyelid is not something to ignore, even when it seems minor. An early assessment is the best way to understand what you are dealing with and get ahead of it. Call 515.875.9480 to schedule an appointment with an oculofacial plastic surgeon today.