![]() If excision is performed it is recommended that histopathologic confirmation of the excised lesion be performed every time. Surgical management includes transconjunctival incision and curettage. 3 Conservative treatment with warm compresses or topical steroids is often sufficient. Data on the frequencies is difficult to come by, but in one recent review chalazia represented nearly half of all eyelid lesions encountered in an ophthalmology practice. Chalazion presents as chronic, localized swelling of the eyelid and typically affects the meibomian glands or glands of Zeis ( See Figure 1).They were treated with incision and drainage, and the biopsy was consistent with chalazion. Multiple chalazia located in the right lower lid of a 74-year-old female. 3 It can be helpful to categorize eyelid lesions into inflammatory, infectious and neoplastic.įigure 1. Benign lesions of the eyelid represent upwards of 80 percent of eyelid neoplasms, while malignant tumors account for the remaining, with basal cell cancer the most frequent malignant tumor. 1,2Īmong tumors encountered by ophthalmologist the most common neoplasms are those of the eyelid. Reports of clinically accurate diagnoses ranged from 83.7 percent to 96.9 percent with between 2 percent and 4.6 percent thought to be clinically benign but found to be histologically malignant. A picture can be priceless for following disease progression or response to treatment.Īlthough experienced clinicians may feel comfortable in their diagnosis, any doubt in clinical judgment should push the clinician for a histologic examination. Finally, a physical examination of the patient should include palpation of the edges and/or fixation to deeper tissues, and assessment of regional lymph nodes and the function of cranial nerves II-VII. The clinician should be assessing for any ulceration with crusting or bleeding, irregular pigment, loss of normal eyelid architecture, pearly edges with central ulceration, fine telangiectasia or loss of cutaneous wrinkles. Physical examination should include assessment of location, the appearance of the surface of the lesion and surrounding skin including adnexal structures. Other pertinent points include a history of skin cancer, immunosuppression, fair skin or radiation therapy. History should include chronicity, symptoms (tenderness, change in vision, discharge), and evolution of the lesion. ![]() The examination of an eyelid lesion begins with history. The eyelid margin consists of the skin, muscle, fat, tarsus, conjunctiva and adnexal structures including the approximately 100 eyelashes, glands of Zeis, glands of Moll, meibomian glands and the associated vascular and lymphatic supply. To diagnose eyelid lesions one must first understand the anatomy of the eyelid and especially the eyelid margin and its characteristics. Here we offer a brief review of some of the more common eyelid lesions that an ophthalmologist may encounter in a general practice. When in doubt, any suspicious lesion should undergo biopsy. Accurate diagnosis by an ophthalmologist is based on history and clinical examination. Eyelid lesions are more often than not benign.
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