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What's that bump on my eyelid?
Oftentimes, patients visit an eye care professional with a specific problem, such as an inflammation or swelling of one or more of the eyelids. There are a few disease processes that can cause such an appearance,and this article will help differentiate the causes. Specifically, information on a stye, chalazion, and basal cell carcinoma will be discussed.
A stye (or hordeolum) develops when an eyelid gland becomes infected. Similar to a pimple on the face,a stye is essentially a clogged pore of the eyelid.The eyelid contains pores along the inner surface, called meibomian glands, and there are also pores from which the eyelashes originate. Styes can originate from either of these oil-rich glands.
A stye initially brings pain, redness, tenderness and swelling in the area,and then a small bump appears. In most cases, the immediate area adjacent to the affected gland is swollen. However, the entire eyelid may become swollen, leading to a more serious eyelid cellulitis. Styes are often caused by staphylococcal bacteria. This bacteria is ubiquitous on human skin, and often enjoys colonizing oil-rich glands on the face and eyelid.
With conservative treatment such as hot compresses,most styes heal within a few days on their own.The application of heat will relieve the pain and bring the stye to a"head."Subsequently, the stye will rupture and drain. However, if the stye fails to drain or evidence of cellulitis is manifest, it may need to be opened and drained by your ophthalmologist, and topical and oral antibiotics may be necessary.
Another type of eyelid lesion is a chalazion, an enlarged,blocked oil gland in the eyelid.A chalazion often arises from a site of a previous stye,and manifests as a chronic, often painless swelling of the eyelid. Chalazia don't cause immediate harm to the patient,but some larger chalazia may be cosmetically unappealing and can induce a small amount of astigmatism.
Chalazia may linger for one to several months,but if the chalazion remains after several months, your ophthalmologist may elect to drain it or inject a steroid to facilitate drainage.
Basal cell carcinoma (BCC) is a form of skin cancer of the face and eyelid that deserves special attention, and occurs predominantly in the elderly population. Although this form of cancer is rarely fatal, it can cause extensive damage and even loss of the eye if left untreated.Most com- monly,BCC presents as a firm, shiny, pearly nodule with fine threadlike vessels on the eyelid,most often on the lower eyelid. It may be slow growing,pigmented, or may bleed with inadvertent rubbing. Undetected or left untreated, the tumor nodule may undergo central ulceration and erode the tissue beneath or adjacent to the eyeball,or destroy the entire eyelid and face.
Patients who come to the office with BCC often have a nonhealing ulcer that often bleeds with mild trauma,and patients may have a long history of sun exposure early in life and/or an outdoor occupation.These lesions are often painless.
In most cases,BCC can be eradicated with early detection and immediate surgical removal. Depending on the lesion size, most BCC can be removed as a minor procedure in the office or operating room.All BCC specimens are examined in the laboratory following excision to ensure that all of the tumor cells have been removed. In advanced cases, extensive plastic surgery may be needed to remove the BCC and reconstruct the eyelid.
Needless to say, eyelid lesions can range from a simple infection or swelling to a potentially sight-threatening cancer. Regular medical eye examinations are key to early identification and treatment of all lesions of the eyelid.
Dr.Prinze C.Mack practices at Freehold Ophthalmology, LLC with offices in Freehold, Toms River and Brick. For more information, visit www.freeholdeye.com
Editorial note: Dr Prinze C. Mack can be found at www.mackeye.com with offices in West Long Branch.