All about eyelid lumps

Eyelid lumps can appear in many forms and have a range of different causes. While eyelid lumps are generally benign, some may cause symptoms or be bothersome in appearance.

Here to provide an expert insight into eyelid lumps is Mr Robert Peden, renowned consultant ophthalmic and oculoplastic surgeon based in Edinburgh.

Can you explain the different types of eyelid lumps, and how do they typically present?

There are various types of eyelid lumps that can occur, and each type may present differently.

Common types of eyelid lumps include:

• Stye: A stye is a small and painful abscess (a collection of pus) on the eyelid that can be quite tender to the touch. It often appears as a red or pink lump with a yellow spot in the middle. The area around the stye may also be swollen or red, and there may be an excessive tearing in the affected eye.
• Chalazion (plural: chalazia): A chalazion is usually larger than a stye, and it appears as a firm lump on the eyelid that may be red or skin-coloured. If a chalazion presses against the eye, it may cause mild discomfort, light sensitivity, and blurred vision.
• Xanthelasma: Xanthelasma are small and yellow areas of fatty cholesterol deposits that typically develop underneath the skin around the eyelids. They can appear as flat strips or as raised bumps. Although generally painless, xanthelasma are unlikely to resolve without treatment and may be cosmetically bothersome.

The appearance and symptoms of eyelid lumps can vary, and a correct diagnosis is crucial to determine the most appropriate course of action.

What can cause eyelid lumps, and what are the underlying medical conditions associated with their development?

Eyelid lumps can have various causes, and some may be associated with underlying medical conditions.

Styes form when an oil-producing gland (called a meibomian gland) or an eyelash follicle become infected by bacteria - usually the Staphylococcus aureus bacteria. This bacteria causes inflammation within the eyelid.

Chalazia are caused by a blockage of one of the meibomian glands. When a meibomian gland becomes blocked, this can lead to inflammation and the accumulation of oil in the eye, resulting in the formation of a chalazion.

Xanthelasma are caused by high levels of cholesterol in the blood, which lead to the accumulation of cholesterol deposits within the skin of the eyelids.

What is the non-surgical treatment for an eyelid lump? When is surgery required for its removal?

The choice of treatment for an eyelid lump depends on the specific type of lump and its underlying cause.

Conservative treatment for eyelid lumps involves:

• Warm compresses: For early-stage styes or chalazia, warm compresses can often help. Applying a clean, warm, damp cloth to the affected area for about 10-15 minutes several times a day can help reduce inflammation and encourage drainage.
• Antibiotics: In some cases of eyelid infections, topical antibiotics or eye drops may be prescribed. For more severe infections, oral antibiotics may be prescribed to clear the infection.
• Medications: In some instances, medications may be prescribed to manage underlying medical conditions associated with eyelid lumps, such as medication to lower the level of cholesterol in the blood for xanthelasma cases.

Surgery may be required if conservative treatments are ineffective. There are two main procedures:

• Incision and drainage: Incision and drainage is a minor surgical procedure often used for styes or chalazia that don’t respond to warm compresses or medication. During the procedure, your surgeon will make a small incision on the eyelid to drain the pus.
• Excision: Excision may be recommended for xanthelasma if it interferes with vision or for cosmetic reasons. During the procedure, your surgeon will surgically remove the yellow deposits of cholesterol and then close the incisions using dissolving sutures.

What are the potential risks and complications associated with the surgical removal of an eyelid lump?

Eyelid lump removal, like any surgical procedure, carries certain potential complications.

There is a risk of infection following eyelid surgery, which is commonly indicated by redness, swelling, warmth, pain and discharge from the surgical site. Infections, however, can be treated with antibiotics.

In addition, and depending on the surgical technique, there may also be a bit of visible scarring. Your surgeon, however, can work to minimise the scarring, often by placing incisions within natural eyelid creases.

Although rare, allergic reactions to the anaesthesia are also possible.

It’s important to discuss any potential complications with your surgeon before having eyelid lump removal. Your surgeon will assess your specific situation, explain the risks and benefits, and provide post-operative instructions for your care and recovery. Attending follow-up appointments can also help minimise the risk of complications and ensure the best possible outcomes.

What can I do to prevent future eyelid lumps?

Preventing future eyelid lumps involves maintaining good eye and eyelid hygiene, as well as addressing any underlying medical conditions that may contribute to their development.

Here are some steps you can take to reduce the risk of future eyelid lumps:

1. Maintain hygiene: Clean your eyes regularly, especially if you are prone to styes or chalazia, using a mild eyelid cleanser or baby shampoo diluted with warm water. Gently scrub the base of your eyelashes to remove debris and bacteria. If you wear eye makeup, remember to remove your makeup before bedtime using a gentle cleanser to prevent clogged oil glands and reduce the risk of infection. Wash your hands frequently, and avoid touching your eyes with dirty hands.
2. Protect your eyes: Use appropriate eye protection when necessary, such as safety glasses or goggles, to prevent foreign bodies from entering your eyes. Wear sunglasses with UV protection to shield your eyes and eyelids from the sun's harmful rays as well, which can help reduce the risk of skin lesions and skin cancer.
3. Manage underlying medical conditions: If you have underlying medical conditions like blepharitis (eyelid inflammation), seborrhoeic dermatitis, or high cholesterol, consult a healthcare professional on how to manage and treat these conditions.
4. Eye exams: Schedule regular eye examinations with a healthcare professional to detect and address any eye-related issues early.

If you notice a new eyelid lump or a change in your eyelid, seek medical attention promptly for an accurate diagnosis and appropriate treatment. Early intervention can improve outcomes.

If you’re worried about a new eyelid lump, don’t hesitate to book an appointment with Mr Robert Peden via his Top Doctors profile today to receive expert diagnosis and treatment.