#18. Tumours of the eyelids and conjunctiva

Question 1

What are the 2 TUMOURS of the EYELIDS?

Answer 1

1) BENIGN TUMOUR of the Eyelids

2) MALIGNANT TUMOUR of the Eyelids

Question 2

What are the BENIGN TUMOURS of the EYELIDS?

Answer 2

A) XANTHOMA

B) HAEMANGIOMA

Question 3

Describe XANTHAOMA’s (Benign Eyelid)

Answer 3

• Bilateral
• Symmetrical
• SLIGHTLY RAISED Yellow Plaques, NEAR INNER CANTHUS
• MORE COMMON in
  a. ELDERLY Women
  b. DIABETICS with EXCESS Cholesterol

Question 4

Describe HAEMANGIOMA’s (Benign Eyelid)

Answer 4

• Occur as LOCALISED CAPILLARY Angioma / CAVERNOUS Angioma
• Lid may be affected along with FACIAL Angioma in STURGE-WEBER SYNDROME
• Occurs at LID MARGIN
  a. Skin / Conjunctiva
  b. Can be REMOVED VIA EXCISION
  c. May become MALIGNANT (Neurofibroma)
• PLEXIFORM TYPE affecting the UPPER Lid in VON RECKLINGHAUSEN’s DISEASE
• THICKENED Nerves can be felt THROUGH Skin as HARD CORDS

Question 5

What are the MALIGNANT TUMOURS of the EYELIDS?

Answer 5

A) SQUAMOUS CELL CARCINOMA

B) BASAL CELL CARCINOMA (Rodent Ulcer)

Question 6

Describe SQUAMOUS CELL CARCINOMA of Eyelid (Malignant Eyelid)

Answer 6

• Affects ELDERLY Person
• Seen at EDGE of Lid = Transition Zone, where Epithelium Changes!
• STARTS as Nodule, THEN ULCERATES
• PRE-AURICULAR Lymph Nodes are ENLARGED
• Tx via COMPLETE EXCISION!

Question 7

Describe BASAL CELL CARCINOMA of Eyelid (Malignant Eyelid)

Answer 7

• MOST COMMON Malignant Tumour of Eyelid
• Seen in LOWER lid, NEAR INNER CANTHUS
• LOCALLY Malignant
• EPITHELIAL GROWTH spreads UNDER the skin in ALL Directions
• INVADES / DESTROYS the lids, orbit AND bone

**IF SMALL = Complete Excision
**IF LARGE = Radiation Therapy

Question 8

What are the 5 TUMOURS of the CONJUNCTIVA?

Answer 8

1) Congenital

2) Papilloma

3) Simple Granuloma

4) Squamous Cell Carcinoma

5) Pigmented Tumours

Question 9

What are CONGENITAL TUMOURS of the CONJUNCTIVA?

Answer 9

E.g. DERMOID = They are CHORISTOMAS that are YELLOW-GREY in colour

• Smooth, Solid, Round Lesions
• Consists of Epidermoid / Epithelium / Sebaceous Glands / Hair
• Found along the Corneal Margin on the OUTER SIDE of LIMBUS
• DISSECTED OFF + REPLACED by LAMELLAR CORNEAL Graft for COSMETIC

E.g. DERMOLIPOMAIS = Found on OUTER CANTUS
- Consists of Fibrous Tissue AND Fat
- REMOVED Surgically

Question 10

What are PAPILLOMA TUMOURS of the CONJUNCTIVA?

Answer 10

• Occur at:
  a. INNER Canthus
  b. Fornices
  c. Limbus

** MUST BE REMOVED, before they turn MALIGNANT

Question 11

What are SIMPLE GRANULOMA TUMOURS of the CONJUNCTIVA?

Answer 11

• Consist of EXUBERANT GRANULATION Tissue
• Is a POLYPOID
• Seen at the CHALAZION SITE (Insufficiently Scraped)
• COMPLETELY REMOVED via SCISSORS

Question 12

What are SQUAMOUS CELL CARCINOMAS of the CONJUNCTIVA?

Answer 12

• Occurs at LIMBUS or LID MARGIN
• SPREADS OVER Surface + INTO the Fornices
• PENETRATE the eyeball
• It GETS REMOVED + CAUTERISED via DIATHERMY
• If it RE-OCCURS = Eye gets ENUCLEATED

Question 13

What are PIGMENTAL TUMOURS of the CONJUNCTIVA?

Answer 13

• Naevi / Congenital Mole (RARELY Malignant)
• PRE-Cancerous
• Occurs in LIMBUS of ELDERLY People
• SPREADS OVER the Surface of the eyeball