What Causes Eyelid Lesions? 

Eyelid lesions are usually benign or pre-malignant, but in some cases, they can have malignancy. At the time of your consultation, the eye surgeon will diagnose the type of eyelid lesions and will determine the possible cause of this condition. Based on their evaluation, they will prescribe an appropriate treatment plan.  

Oculoplastic surgeon and board certified ophthalmologist Dr. Jennifer Hui provides a wide range of eye care procedures to patients in Palm Springs, Palm Desert, La Quinta, Coachella Valley, Riverside, Redlands, Yucaipa, Loma Linda, and surrounding locations. 

A number of benign or pre-malignant lesions, such as actinic keratosis (AK), seborrheic keratosis (SK), and Bowen’s disease may occur because of direct or chronic sun exposure. These eyelid lesions typically occur on the lower eyelids. These lesions often cause only cosmetic concerns, but sometimes they may induce conditions such as astigmatism or disfigurement of the eyelid.  

To determine the cause behind the occurrence of the eyelid lesion, your eye surgeon will examine your symptoms and medical history. If you have symptoms such as discharge, tenderness, or changes in vision, it could indicate the presence of a lesion. 

The surgeon will evaluate the history and evolution of the lesion, and will also consider whether you have had a history of immuno-suppression, skin cancer, or have a fair skin and have received radiation therapy.  

Inflammatory lesions, such as Chalazion, are marked by localized, chronic swelling of the eyelid. The condition usually affects the meibomian glands. Infection lesions, such as molluscum contagiosum, may be present as waxy and pale nodular cysts. Patients with this type of eyelid lesions are typically young. AIDS patients have a higher incidence of this condition because of their reduced T cell count. 

Neoplastic lesions, such as squamous cell papillomas, develop from proliferation of epidermis. Epidermal inclusion cysts may occur as smooth, elevated, and growing cysts. They can arise from entrapment of the epidermal tissue in the dermis. Rupture with release of keratin may cause an inflammatory reaction of the foreign body. 

Seborrheic keratosis (SK) is an acquired benign eyelid lesion affecting elderly patients. Actinic keratoses (AK) are eyelid lesions present as scaly and round hyper-keratotic plaques with a rough texture. They are a common type of precancerous skin lesion and usually affect older patients with fair complexion and long-term sun exposure. 

Keratoacanthoma eyelid lesions can be present as flesh-colored papules. They are often found on the lower eyelid in patients who have experienced chronic sun exposure. Some immuno-compromised patients may also develop this condition. 

Basal cell carcinoma (BCC) represents about 90 percent of malignant neoplasms in the periocular region. This condition occurs primarily in people who are in their middle age or older and may have fair skin. In some cases, it may also occur in African Americans.

Squamous cell carcinoma (SCC) is the second most common type of malignant eyelid lesion. In a majority of cases, this lesion occurs in the lower eyelid. Sun exposure, immune-suppressive drugs, HPV infection, and exposure to radiation or arsenic may cause this malignant lesion.