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Eyelid Lumps and Bumps — Types, Causes, & Risk Factors

May 14, 2023/0 Comments/in Armadale Eye Blogs, Oculoplastic Surgery /by armadaleeye

So, you’ve glanced in the mirror and just noticed a little bump on your upper eyelid. Is this something to be worried about? Could it be skin cancer, or is it just a benign lesion? Do you need to see someone about it? There are many types of eyelid bumps and lid lesions; some need urgent attention, while others will resolve with simple warm compresses. This is what you should know about eyelid bumps and lesions.

Styes and Chalazia

Styes and chalazia are often confused – many people will classify a chalazion as a stye. However, they are two separate types of benign eyelid lesions.

A stye, also known as a hordeolum, may be internal or external. They can appear along the eyelid margin or further within the lid. An external stye is a bacterial infection of the sebaceous glands around the eyelashes, known as the glands of Zeis and Moll; it can look like a pimple. Conversely, an internal stye is an infection of the oil glands deeper within the lid, known as the meibomian glands. These look like a red, soft bump on the eyelid. There are numerous oil glands on both the upper and lower eyelid, so you may find you can have more than one eyelid bump at a time. Styes tend to be red and painful to touch and can start as a generalised swelling of the lid tissues.

Chalazia, or singular chalazion, is a blockage of a meibomian gland of the lid. Unlike a stye, it doesn’t involve an active infection. A chalazion may appear as a slightly tender, red, swollen bump on the lid but more often presents as a painless lump without redness. They are more common on the upper eyelid but can appear on the lower eyelids too.

Treatment for Styes and Chalazia

Your stye or chalazion will resolve on its own without intervention. Oral antibiotics are not necessary as the drug doesn’t reach these lid lesions in any useful concentration. Instead, applying warm compresses several times a day can help the body to clear the clogged gland more quickly.

However, if the bacterial infection associated with a stye progresses to an infection of the surrounding tissues, known as preseptal cellulitis, this will require antibiotic treatment.

Never try to pop these eyelid lesions, as it can result in scarring or a secondary infection.

In some cases, a chalazion can hang around for months – if this becomes bothersome, you may choose to see an eye surgeon for surgical excision and drainage.

If you have a stye or chalazion, it’s a good idea to avoid wearing eye makeup and contact lenses as these can cause further irritation and prolong the healing process.

Other Common Eyelid Bumps

Skin tags are benign eyelid lesions more common in elderly patients. They appear as small growths on the skin attached by a tiny stalk. Skin tags can vary in colour and size, and even texture.

Seborrheic keratosis is a discoloured, wart-like bump also more common in older patients. Like a skin tag, it’s not necessary to treat seborrheic keratosis unless it bothers you for cosmetic reasons.

Milia are tiny white bumps on the eyelid skin and cheeks. These are cysts that form due to dead cells trapped under the surface of the skin. These tiny white bumps are common in infants and children.

Molluscum contagiosum is caused by a viral infection, most commonly in children. Typically, this viral wart appears only around one eye and can be contagious through physical contact. It’s generally safe to let it resolve on its own over weeks, but you should exercise impeccable hygiene to avoid transmitting the virus to others.

Squamous papilloma is a very common benign tumour, often found in middle-aged or older adults. It appears as a skin-coloured growth on the eyelids and doesn’t need any treatment.

Eyelid Bumps and Malignant Lesions

Though most lid bumps are benign lesions, it is possible to develop malignant eyelid tumours as well. To the untrained eye, it can be difficult to determine whether an eyelid bump is a malignant lesion or not. For this reason, even if you suspect your eyelid bump is just a stye or a chalazion, any new bumps should be checked by an optometrist or eye specialist for accurate diagnosis. This is especially true if the eyelid bump bleeds, is flaky or scaly, disrupts your eyelash line, or continues to grow over time.

Basal Cell Carcinomas

Basal cell carcinoma is the most common malignant lesion found on the eyelids, representing about 90% of eyelid malignancies. It’s most frequently found on the lower eyelid and in individuals with fair skin but can happen with any skin complexion.

Treatment is always recommended, as cancer cells can spread. Treatment modalities include using topical medications, though this is not as effective as complete excision with an eye surgeon specialising in oculoplastics.

Squamous Cell Carcinoma

Squamous cell carcinoma is much rarer than basal cell carcinoma. Still, it tends to spread more aggressively, including orbital invasion (of the eye socket) and distant metastasis to regional lymph nodes or parts of the body further away from the eye.

The treatment of choice is to have the lesion completely surgically removed, such as with a technique known as Mohs micrographic surgery.

Sebaceous Cell Carcinomas

This type of cancer arises from an oil gland of the eye, such as a meibomian gland. Sebaceous cell carcinomas can also spread aggressively and must be treated promptly.

Risk Factors for Lid Malignant Lesions

Understanding your risk for skin cancer can help you to respond more quickly if you notice a suspicious lesion around your eyelids.

Factors that increase your chances of developing a malignant eyelid bump include:

Fair or light complexion
Older age
Ultraviolet exposure
Certain viruses, such as HIV
Immunosuppression
Skin conditions involving damage, such as from old burns or previous scarring

Though most lid lesions are harmless, any bump that is new and unusual should be checked out by a qualified eye care professional by calling on (03) 9070 5753. You may require monitoring over time for changes, or if the lesion exhibits obviously suspicious features of malignant transformation, prompt treatment may be needed.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

Eyelid lesions in general practice
https://www1.racgp.org.au/ajgp/2019/august/eyelid-lesions-in-general-practice

Styes
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/styes

chalazion vs stye melbourne vic

Chalazion vs Stye – Understanding the Differences of 2 Eyelid Bumps

February 15, 2021/0 Comments/in Armadale Eye Blogs /by armadaleeye

Our eyelids are delicate structures but are also a lot more intricate and functional than we give them credit for. Most of us will experience a little lump or bump on an eyelid at some point in our lives – some of these eyelid bumps are harmless while others need the attention of a specialist in oculoplastic surgery. Out of all the garden variety eyelid bumps, the most commonly confused are a chalazion vs stye.

The Eyelid

Understanding a little of the anatomy of the human eyelid will help us to have a better grasp of the difference between a chalazion vs stye.

Our eyelids serve several purposes, including physically protecting the sensitive surface of the eye as well as providing lubrication via several different glands. The eyelid is made up of layers of smooth muscle, connective tissue, fibrous tissue, a mucous membrane known as conjunctiva, and various secretory glands. Lining the upper and lower eyelid margins are a particularly important set of glands known as the meibomian glands, which open their orifices just behind the eyelash line. The oily secretion produced by these glands is called meibum, which has the purpose of lubricating the surface of the eye, keeping these tissues healthy and contributing to clear vision.

Each eyelash follicle is paired with two additional types of glands known as the glands of Zeis and Moll. The glands of Zeis are sebaceous glands while the glands of Moll are modified sweat glands. Both of these glands support the health of our eyelashes, with their secretions keeping the lashes from becoming brittle.

While the glands of our eyelids are certainly useful, they can also be subject to infection and blockages, much like other glands throughout our bodies. It’s then that you may experience one of those inconvenient little eyelid bumps.

Chalazion vs Stye

Chalazia and styes are among the most common lumps and bumps found on the eyelid. Although both are considered benign, both types of eyelid bumps can be a cause of concern for many people, particularly if the lump is large, sore, or red, leading them to enquire about oculoplastic surgery. The underlying cause is what differentiates a chalazion vs stye, although many people will use the term “stye” to cover both types of bumps.

A chalazion (plural, chalazia), is a blockage of a meibomian gland in the eyelid without an active infection. Initially a chalazion may begin as a stye but then eventually the infection resolves, leaving behind a painless bump that we then call a chalazion. A chalazion is made up of blocked meibum accumulating in the surrounding soft tissues of the eyelid as its usual drainage route through the duct is obstructed. The main concern for someone with a chalazion is not pain or redness, even when the chalazion is touched, but more of a cosmetic issue. A chalazion can vary in size, with some being large enough to put some pressure on the cornea and causing temporarily blurred vision. Unfortunately, chalazia are known to take some time to clear, from weeks to months.

On the other hand, a stye, also known as a hordeolum, involves an active infection. An external stye is due to an infection of one the glands of Zeis or Moll, and typically appears as a yellowish-whitish pimple around the base of the affected eyelash follicle. Conversely, an internal stye or hordeolum involves an infection of a meibomian gland inside the eyelid. It’s an internal stye that is most likely to be confused with a chalazion as they both appear as bumps under the skin of the eyelid. Because there is an active infection, styes are typically sore and associated with redness and inflammation.

Treatment

Most styes and chalazia will self-resolve without needing intervention from an oculoplastic surgery doctor. To hasten the healing process, you may consider using a gentle warm compress over the affected eyelid in order to encourage blood flow to the area, or your optometrist and GP may pluck the eyelash associated with an external stye to help drainage of the blocked glands. As tempting as it may be, however, you should never try to pop a chalazion or stye as this will potentially exacerbate the lesion. Some eyecare practitioners may prescribe a topical antibiotic ointment for an external stye but these should be avoided in the case of chalazia as there is no infection.

Large chalazia and styes that are taking a long time to self-resolve with home remedies such as a warm compress can be referred to an ophthalmologist experienced in oculoplastic surgery. For very stubborn chalazia, the eye specialist can perform a surgical procedure to remove the contents of the chalazion, known as an incision and curettage. There is also the option of steroid injections into the eyelid to help the chalazion to resolve more quickly.

Styes and chalazia are known to recur, whether in the same area of the eyelid or elsewhere. Several risk factors have been identified in the likelihood of developing recurrent styes and chalazia, such as having acne rosacea or meibomian gland dysfunction. A chalazion that frequently pops up in the same area may require examination by an ophthalmologist to rule out any other conditions that may mimic a chalazion, such as an eyelid carcinoma.

Call us today at (03) 9070 5753 for more info.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.