Minor & benign Eyelid Lesions

Cysts of Moll

Glands of Moll live along the base of the eyelashes. and the glands of Moll secrete clear secretions. If the opening to the glands are blocked, they form cysts. Initial treatment is to use hot compresses. The heat and pressure may resolve the cyst, especially in the early stages. If these do not resolve then surgical excision is a minor procedure.

Cyst of Zeiss

Glands of Zeiss live along the base of the eyelashes and are filled with oily secretions. If the opening of the glands are blocked, they can form a cyst of Zeiss.

Initial treatment is to use hot compresses. The heat and pressure may resolve the cyst, especially in the early stages. If these do not resolve then surgical excision is a minor procedure.

Eyelid Papilloma

Papilloma of the eyelid are benign tumours and carry little to no risk of change to any form of cancer. They can be solitary or multiple and can either have a smooth or rough (corrugated) edge surface and they are usually of a similar colour to the surrounding skin. They may cause mild irritation or may be cosmetically unacceptable to the patient. There are a few different sub types of papilloma and the most common is the squamous papilloma, otherwise known as a skin tag. This is usually soft flesh coloured smooth or pedunculated.

Inverted Follicular Keratosis

Inverted follicular keratosis is usually a solitary lesion of the eyelid margin, which may or may not be pigmented and can be of a nodular papillary in appearance and finally the verruca vulgaris is a flesh-coloured growth caused by the human papilloma virus and this can also be found on the eyelid.

Seborrhoeic Keratosis

Seborrheic keratosis is one of the most common skin lesions of the eyelids, occurring on the face or trunk of middle aged or elderly people. Accounting for 10% of all eyelid lesions, they are unrelated to actinic (solar) damage. Solitary lesions of seborrheic keratosis are uncommon. They are superficial, brown or black lesions which are well circumscribed, slightly elevated and have a greasy or waxy keratotic surface. This gives them their “stuck-on” appearance. There is usually no extension into the dermis and no inflammation, and if either of these is present basal cell carcinoma (BCC) or squamous cell carcinoma (SCC) must be considered. Because seborrheic keratosis is benign, therapy can be conservative and limited to biopsy for confirmation of benign status. Otherwise therapy is for cosmesis or comfort. Cryotherapy is effective for thin keratoses whereas thicker lesions may be curetted off or excised under local anaesthesia.

Xanthelasma

Xanthalsma is a harmless yellow-coloured deposit that forms in the eyelids as a result of cholesterol deposition in the skin.

In itself, it is a harmless condition but it can be related to some other underlying conditions such as high cholesterol (around 50%), high blood pressure, diabetes or thyroid conditions. Obesity and high alcohol intake are also modifiable risk factors for Xanthelasma. There is an increased cardiovascular risk, including an increased risk of heart attack and consultation with a general physician is advisable.

Treatment is most commonly sought for cosmetic reasons and it may be a surprise to find you are advised to have further tests and possibly treatment for the above conditions, however these may prove to be more important than the Xanthelasma itself. Several treatment options are available including cryotherapy and surgical excision. As these often occur around the eyes and eyelids, these are ideally treated by a specialist Oculoplastic surgeon to avoid a number of potential complexities with surgery in this area.

Recovery is as for any eyelid surgery, however there is a higher chance of the Xanthelasma recurring over time in the same area although this can be reduced by treating some of the underlying causes listed above.