The eyelid is a complex structure which contains many different tissue components, each of which can give rise to a different type of eyelid lump. By far the most common eyelid lump is a chalazion which is a cyst of one of the oil producing glands of the eyelid. these can be removed simply under local anaesthetic in the clinic with a hidden incision on the inside of the upper eyelid.
A variety of other benign lumps and bumps such as sweat gland cysts, sebaceous cysts and warty growths are also common on the eyelid and can be removed simply and safely. This is often done under local anaesthesia. Xanthelasma is another common benign eyelid lesion which is a result of cholesterol deposition on the inner parts of the upper and lower eyelids and can readily be removed.
The eyelid is also a very common site for malignant tumours such as basal cell carcinoma (BCC) and other forms of skin cancer. Basal cell carcinoma presents as a painless hard lump, most commonly on the lower eyelid, which grows slowly to invade and destroys deeper tissues. It is essential that these are removed as early as possible.
The key principles of management for malignant eyelid lesions are complete surgical removal followed by reconstruction. The tumour excision can be achieved either be achieved by an oculoplastic surgeon, or by a dermatologist using Moh's technique if the tumour is in a sensitive or critical area. After confirmation that the tumour has been removed, the eyelid tissues are then reformed. Eyelid reconstruction is a highly specialised form of surgery which should only be performed by an oculoplastic surgeon.