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Eyelid Lumps and Bumps Q&A

Mr Vikas Chadha, one of our top Consultants Ophthalmologists at BMI Ross Hall Hospital, offers his insights into different types of eyelid lumps and bumps, their treatment and prevention but also his career as an ophthalmologist.

Mr Chadha is also part of Eye Care Scotland, the new eye care centre at BMI Ross Hall Hospital.

What kind of lumps or bumps appear on the eyelid?

Majority of eyelid lumps and bumps are benign (not tumours) and may be styes, chalazions, xanthelesma, skin tags, warts, cysts, freckles etcetera. However, the eyelids are also a common site for skin cancers, especially basal cell carcinomas (known as rodent ulcers).

What lumps and bumps should I be worried about?

Common lumps and bumps can usually be recognised. Styes appear as red, uncomfortable or painful bumps at the lid margin. Chalazions or Meibomian cysts are non-tender smooth bumps on the lid margin. Xanthelesmas are pale or yellowish-orange cholesterol deposits which occur on the inner aspects of the upper and lower eyelids. Skin tags and warts on the eyelids are no different from those appearing elsewhere in the body.

It can sometimes be difficult for a non-clinical person to be sure that the eyelid lump is not a rodent ulcer or some other cancer. It is, therefore, important, that any eyelid lump or bump patients are unsure of are examined by their optometrist or general practitioner. They will be able to advise if it has any suspicious features and needs to be referred to an oculoplastic specialist (ophthalmologists or eye doctors with special expertise in eyelid problems).

Why do these lumps and bumps appear?

Styes occur when bacteria enter and inflame the oil glands on the lid margins. The risk of having styes increases if the patient has a condition called blepharitis, which is inflammation of the eyelid margins.

A chalazion can form when the oil glands in the eyelids are blocked. There may not necessarily be an infection associated with it.

Xanthelasma occurs when there are collections of fat just below the surface of the skin. They can sometimes indicate that the patient has an underlying condition that causes high cholesterol or they can form without any association to any medical conditions.

How can we treat such problems?

Benign (non-cancerous) lumps and bumps such as styes and chalazions can be treated with conservative measures. Many others can be removed under local anaesthesia in the clinic setting or as day-case surgery.

The local anaesthetic injection results in a little nip for 10-20 seconds but once that's done, the rest of the procedure is completely painless for the patient. There is also very little post-operative pain.

Treatment of cancers very much depends on the type of cancer and its extent. The consultant may decide to do a small biopsy in clinic before deciding on the final treatment plan. The final surgery may be in stages or in one sitting and may be under local or general anaesthesia. The consultant will always discuss these details with the patient during the consultation and the patient is an integral part of the decision-making process.

Is there a way to prevent eyelid bumps?

Eyelid lumps and bumps cannot be truly prevented. If a patient suffers from recurrent Meibomian cysts (or Chalazions), then regular eyelid hygiene and warm compresses can reduce the chances of their recurrence.

What made you become a consultant ophthalmologist?

The eye is one of the most important organs of the body from both functional (vision) and aesthetic points of view. The combination of medicine and surgery in the speciality of ophthalmology attracted me to it. The surgery is intricate and clean; the results gratifying. My sub-speciality of ocular oncology brings with it even greater satisfaction in terms of helping and supporting people going through what may be the most difficult time of their lives.

What is your career highlight to date?

I have now been involved in the organisation of two annual meetings for the British Oculoplastic Surgery Society (BOPSS). The most recent one in Glasgow in 2016 was one of the most successful meetings and brought together some of the best Oculoplastic Surgeons in the world. However, the greatest moments in my career have come from the small notes of appreciation that I often receive from my patients in the form of phone calls, emails and cards. .

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