Eyelid and facial lumps and bumps, and skin lesions, are common.
Your specialist ophthalmic surgeon will assess whether the lesion is benign or potentially malignant and be able to recommend the best treatment to remedy the situation. Often small lumps or lesions can be removed in the clinic treatment room under a simple local anaesthetic. Suspicious lumps are sent to a pathologist for analysis (a biopsy) and a result is available within a week or so. Xanthelasmas can be treated with the application of tricholoracetic acid (TCA). For patients who are needle phobic or very anxious, minor surgery can also be performed in our operating theatre under "twilight sedation anaesthesia" provided by an anaesthetist.
What are lumps and bumps?
Eyelid and facial lumps and bumps (lesions) are common in patients referred to ophthalmic surgeons. Many lesions can be readily diagnosed on the basis of their characteristics and these include;
- A chalazion (a blocked up, inflamed melbomian gland). It begins to swell and may become infected.
- A stye (an infection of an eyelash follicle resembling a yellow-headed spot).
- Skin tags, cysts and Milia
- Pigmented and non-pigmented moles
- Raised skin blemishes
A number of other lesions can be readily diagnosed by clinical examination alone. It is important to distinguish malignant from benign lesions. Generally, the majority of malignant tumours affecting the eyelids and area surrounding the eye consist of slowly enlarging, destructive lesions. A number of subtle features may help to differentiate malignant from benign eyelid tumours but it can be difficult to make the correct diagnosis without a biopsy which can be quickly carried out at the clinic.
Who does your surgery?
- Specialist ophthalmic surgeons’ particular area of expertise is in operating on the eyes and the delicate skin around the eyes.
- They can also provide a comprehensive assessment of any underlying medical problems during your discussion of the available treatment options.
What happens at surgery?
Minor cosmetic surgery and surgery for lumps and bumps can be performed under local anaesthesia. Local anaesthesia with intravenous sedation given by an anaesthetist, is also available. For small lesions an excisional biopsy is carried out where the whole lesion is removed to help diagnosis and treatment.
For larger lesions an incisional biopsy is carried out where only a small piece of the lesion is removed to aid the diagnosis. The problem is then treated on the basis of the histology report.
Chalazions and styes
Both of these can be treated with an antibiotic ointment. In most cases there is no special cause, and the chalazion or stye is a one-off.
Xanthelasmata is treated in a few minutes with an application of Trichloroacetic acid (Can be repeated 4-6 weeks later) or occasionally excised.
Skin tags, cysts and milia
Skin tags and milia are minor abnormalities which do not need to be sent to a pathologist for histopathological examination. They can be removed very simply with minimum scarring.
Pigmented and non-pigmented moles and raised skin blemishes
These lesions require a more formal plastic surgery excision and sent to a pathologist for histopathological examination.
Side Effects
Complications in the hands of a trained and experienced ophthalmic surgeon are very rare and all precautions are taken to minimise any risks. An ophthalmic surgeon undertakes eyelid surgery routinely and is trained to prevent and manage any problems.
Any Minor Surgery
- The eye may be covered with a dressing which will help to keep bruising and swelling to the minimum
- Take a simple analgesic if required e.g. paracetamol
- The site should be cleaned and ointment applied to the site as directed.
NOTE: If you have undergone a biopsy the report will be sent to you and to your GP as soon as it has been received from the pathologist. If the lesion is benign and there are no problems you may not need to return to the clinic for a check but in the event of any problems you should call the clinic and arrange a further appointment.