In general, eyelid cysts and lesions are harmless. An ophthalmologist can provide an accurate diagnosis on the basis of history and a clinical exam. All suspicious cysts should be evaluated through a biopsy.
Experienced oculoplastic surgeon Dr. Jennifer Hui of the The Eyelid Institute provides diagnosis and treatment for cancerous eyelid cysts to patients in Palm Springs, Palm Desert, La Quinta, Coachella Valley, Riverside, Redlands, Yucaipa, Loma Linda, and surrounding communities.
The surgeon should have comprehensive knowledge of the structure of the eyelid as well as the eyelid margin and its characteristics to diagnose eyelid lesions and cysts.
The ophthalmologist will conduct a physical exam to assess the location of the cyst, the appearance of the cyst’s surface as well as the surrounding skin including adnexal structures.
The surgeon will detect the presence of any ulceration with bleeding or crusting, uneven pigment, loss of healthy eyelid structure, pearly edges with central ulceration, loss of cutaneous wrinkles or fine telangiectasia.
Lastly, the physical exam will be performed to assess the palpation of the edges and/or fixation to deeper tissues as well as the evaluation of the regional lymph nodes and the function of cranial nerves II-VII.
Over 80 percent of eyelid neoplasms comprise benign cysts or lesions. Cancerous tumors form the remaining approximately 20 percent with BCC being the most often occurring cancerous tumor.
Chalazion manifests as chronic, localized eyelid inflammation that usually impacts the meibomian glands. Many times, all that the patient requires is conservative treatment comprising warm compresses or topical steroids. In case the condition warrants surgical intervention, it usually comprises transconjunctival incision and curettage.
Molluscum contagiosum manifests as waxy, pale and nodular cysts usually with central umbilication. This condition can impact the upper or lower eyelid. The local immune reaction usually successfully destructs the virus.
Excision, cryotherapy or curettage are some of the other treatment options.
Epidermal Inclusion Cysts
Epidermal Inclusion Cysts typically present as raised, smooth and progressively growing cysts that occur when the epidermal tissue gets trapped in the dermis. The rupturing of the cyst with the release of keratin can lead to an inflammatory foreign-body reaction. The treatment of this condition involves excision with retention of the surrounding capsule.
Acquired Melanocytic Nevi
Acquired Melanocytic Nevi are usually molded to the lid margin and appear as melanocytes clumps in the dermis and epidermis. This condition is not usually apparent at the time of birth. However, they increase in pigmentation during puberty.
They usually present as raised, pigmented papules in the second decade. This condition usually does not require any treatment. However, the malignant transformation of a junctional or compound nevus can occur at times and will require excision.
Seborrheic keratosis is a benign condition that affects older adults. The lesions appear greasy and stuck-0n with different levels of pigmentation. Sometimes this condition may require excision, but the chances of recurrence are very high.
This condition is also called sweat ductal cysts. It leads to sweat duct blockage. The cysts manifest as tiny (average of 4mm) transparent, smooth, and soft lesions.