Benign Lumps of the Eyelid
Definition | Chalazion | Stye (Hordeolum) | Milia | Papilloma | Xanthelasma | References
Definition
Benign lumps of the eyelid are non-cancerous growths that occur on or around the eyelid. They can vary in size, appearance, and cause, and are generally not harmful but may cause discomfort or cosmetic concerns.
Chalazion
Definition: A chalazion is a painless lump or swelling that develops on the eyelid due to a blocked meibomian gland.
Aetiology: Blockage and inflammation of a meibomian gland, often secondary to blepharitis or rosacea.
Pathophysiology: The blockage leads to the accumulation of glandular secretions, causing a granulomatous inflammatory response.
Risk Factors: Chronic blepharitis, rosacea, seborrheic dermatitis.
Signs and Symptoms: Painless, firm nodule on the eyelid, often with swelling and mild tenderness initially.
Investigations: Clinical examination, rarely requires further investigation.
Management:
- Warm compresses and lid massage
- Topical antibiotics if secondary infection is suspected
- Referral to an ophthalmologist for incision and curettage if persistent
- Intralesional steroid injection for non-resolving cases
Stye (Hordeolum)
Definition: A stye is a painful, red bump on the edge of the eyelid caused by an acute bacterial infection of the eyelash follicle or meibomian gland.
Aetiology: Bacterial infection, typically Staphylococcus aureus.
Pathophysiology: Infection leads to inflammation and abscess formation at the eyelid margin.
Risk Factors: Poor eyelid hygiene, blepharitis, previous styes.
Signs and Symptoms: Painful, red lump on the eyelid, swelling, and possible discharge.
Investigations: Clinical examination.
Management:
- Warm compresses to promote drainage
- Topical antibiotics (e.g., chloramphenicol ointment)
- Oral antibiotics for severe or recurrent cases
- Incision and drainage by an ophthalmologist if necessary
Milia
Definition: Milia are small, white cysts that occur on the eyelids and other facial areas due to trapped keratin under the skin.
Aetiology: Keratin trapped beneath the surface of the skin, often in newborns or after skin trauma.
Pathophysiology: Small cysts form when dead skin cells are trapped in small pockets near the surface of the skin.
Risk Factors: Newborns, skin trauma, certain skin conditions.
Signs and Symptoms: Small, white, painless bumps on the eyelid or other facial areas.
Investigations: Clinical examination.
Management:
- Generally self-resolving in newborns
- Manual extraction by a healthcare professional if persistent or bothersome
- Topical retinoids in adults to prevent formation
Papilloma
Definition: Papillomas are benign epithelial tumours that can occur on the eyelid, often presenting as small, fleshy, or wart-like growths.
Aetiology: Human papillomavirus (HPV) infection, other factors contributing to epithelial cell growth.
Pathophysiology: Proliferation of epithelial cells leads to the formation of benign tumours.
Risk Factors: HPV infection, advanced age.
Signs and Symptoms: Fleshy, pedunculated, or sessile growths on the eyelid.
Investigations: Clinical examination, biopsy if atypical features present.
Management:
- Observation if asymptomatic and small
- Excision if symptomatic, cosmetically concerning, or suspicious for malignancy
- Referral to an ophthalmologist for surgical removal
Xanthelasma
Definition: Xanthelasma are yellowish deposits of cholesterol that occur on the eyelids, often near the inner canthus.
Aetiology: Lipid metabolism disorders, hyperlipidaemia.
Pathophysiology: Cholesterol deposits form in the skin due to elevated lipid levels.
Risk Factors: Hyperlipidaemia, family history of lipid disorders.
Signs and Symptoms: Yellowish, soft plaques on the eyelids.
Investigations: Clinical examination, lipid profile to assess underlying lipid disorders.
Management:
- Treat underlying hyperlipidaemia
- Laser treatment, cryotherapy, or surgical excision for cosmetic reasons
- Referral to a dermatologist or ophthalmologist for removal
References
- NICE. (2024). Eyelid Lesions: Diagnosis and Management. Retrieved from NICE
- NHS. (2023). Eyelid Lumps and Bumps. Retrieved from NHS
- British Medical Journal (BMJ). (2022). Eyelid Lesions: Diagnosis and Management. Retrieved from BMJ
- American Academy of Ophthalmology (AAO). (2021). Clinical Practice Guidelines: Eyelid Lesions. Retrieved from AAO
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