Eyelid surgery for tumours or lumps
In terms of symptoms for an eyelid tumour or an eyelid lump, patients will come to see us in the first instance because they can see a lump developing on their eyelid, or possibly because they can feel a lump around their eye or around their eyelid area. They may have had it for a few days, or it may have been developing for some time.
The patient may see the lump and book an appointment directly with us or see it and visit their GP in the first instance, or via their optician. If anyone suspects it’s a cancer, they need to be seen quite quickly.
Patients are often worried that they have got a form of skin cancer or some sort of tumour. These don’t tend to be painful; lumps around the eye, with the exception of things like a chalazion (cyst) tend not to be painful or inflamed, and so patients tend to come and see us with just a lump itself.
We examine the lump and try to make a diagnosis using the microscope. We will assess the lump and find out whether we think it’s a benign lump or a malignant lump. Benign lumps are less of a concern, but patients still nonetheless want to have them removed, and there is a range of benign lumps that people can get around the eyelids. Those can usually be removed in the treatment room as a minor procedure – and sometimes on the same day.
A slightly more substantial lump is usually removed in theatre and often under a local anaesthetic.
Usually from the first appointment, the patient will get a provisional diagnosis and often a fairly definite diagnosis. If we remove the lump, we usually get it sent away and checked under a microscope with histology and then they will get a final diagnosis.
Sometimes, we can perform a treatment at a patient’s first appointment, or they may need to be taken to theatre as a separate procedure.
As far as treatment is concerned, nearly always with a lump, we are going to treat it with surgery – and usually that’s a case of either removing the content of a lump if it’s cystic, or in others we will remove the lump itself and send it away for histology – and that often means surgery with a local anaesthetic.
The patient will typically come in, have the local anaesthetic, have the lump removed and go home on the same day with their eye covered over with an eye pad. They then usually have some drops or ointment to use afterwards. Sometimes there are some stitches needed; they’re nearly always dissolving stitches.
Again, the technique we use if we think it’s a cancerous tumour can vary. We aim to remove the whole lump with the first go and there are different techniques we can use; however, we can’t know whether the lump has been fully removed until we get the final results through.
We will follow the patient up in clinic around a couple of weeks later. We will usually then have the results of the histology – i.e. the specimen has been checked.
If everything’s fine, they will be discharged. If it’s a malignant tumour and it’s all gone, that’s usually fine – but we will often still follow the patient up after that. If it’s a malignant tumour and it hasn’t all gone, they may need some further surgery.