BENIGN Eyelid Lumps & Bumps

Question 1

Describe a chalazion/ meibomian cyst?

Answer 1

• Blocked meibomian gland
• Painless, eyelid swelling
• Can present on any eyelid
• Can be present for many months
• Often settles on own w/o treatment or with simple hot compresses
• Treatment only indicated in situations such as where there is a mechanical ptosis or if it gets infected or persists past 6-12 months
• Completely benign lesion

Question 2

Describe an external hordeolum/ stye?

Answer 2

• Acute staphylococcal infection on base of eyelash follicle
• Presents with painful, localised eyelid swelling with small pus point
• Often self-limiting
• Pus point will spontaneously burst with a small amount of pus discharge & then resolves on own
• V rarely progress to cellulitis – which then needs systemic antibiotics
• Advise warm compress and reassure that it will settle down over time

Question 3

Describe molluscum contagiosum?

Answer 3

• Low-grade viral infection causing lesions typically seen in children
• Common around eyelids, in armpits and on chest
• Typical presentation: raised, well-defined lesions, slightly pearly edges with slightly umbilicated centre
• Important to identify as this same presentation can be in patients with Basal Cell Carcinoma which is a malignant lesion
• These lesions do not cause any problems, except when they are on the eyelid & can cause chronic low-grade follicular conjunctivitis
• Treatment: excision if they cause problems or can be left alone and they resolve over time
• No loss of eyelashes

Question 4

Describe a benign epidermoid cyst?

Answer 4

• Presents as smooth, well-defined, white lesion with normal skin architecture over it
• Sometimes with few dilated vessels due to stretching of skin
• Completely harmless and only reason to remove this would be cosmetic

Question 5

Describe a cyst of Moll/ Hidrocystoma?

Answer 5

• Painless, clear, fluid-filled, translucent lesions typically seen on lid margin
• Entirely benign
• Treatment is cosmetic

Question 6

Desrube a dermoid cyst?

Answer 6

• Benign lesion
• Typically occurs either in outer upper corner of orbit or inner upper corner of orbit
• Smooth, well-defined lesion often attached to the orbital rim

Question 7

Describe a benign nevus?

Answer 7

• Simple moles
• Differential Diagnosis: ocular melanoma – malignant
• Any change in size or shape of this over time should raise the suspicion of this being malignant

Question 8

Describe skin tage/ squamous papilloma?

Answer 8

• Typically happen on eyelids, on neck and on armpits
• Benign
• Treatment: surgical excision

Question 9

Describe xanthelasma?

Answer 9

• Deposition of cholesterol just under the skin – typically on upper and lower eyelids
• More common in pxs with raised cholesterol but can happen in anybody
• Does not cause any functional problems but cause cosmetic issues
• Treatment: laser or surgical excision
• Can often recur after treatment