Good Hope Eye Clinic

Eyelid lumps

David Kinshuck

 

Styes

diagram of stye

A stye is an infection in the edge of your eyelid. The infection is in a gland at the base of an eyelash, and is usually caused by staphylococcal bacteria. The treatment you need depends on how severe the infection is. See

 

 

 

 

A photograph of an early stye explanation

stye,the eyecentre.com

 

 

 

 

 

 

 

 

Treatment of styes

very mild infections (a little redness and swelling) can be treated with hot bathing and cleaning of the eyelid.
  • To carry out ‘hot bathing’, bathe the stye with a compress, such as a flannel or tissue, soaked in hot water.
  • The water should not be hot enough to burn, and the bathing is usually need 4 times a day for about 10 minutes, until the stye starts to go, usually 2 days.
  • (Alternatively use hot spoon bathing: hold a spoon with a flannel wrapped round soaked in hot water beneath your eye so the steam rises.)
average Styes that are more painful with more swelling also need antibiotics, such as chloramphenicol cream x4 a day, or fucithalmic x2 from your general practitioner. Take care not to spread the infection to the other eye.
severe Severe styes cause swelling of the entire eyelid may need antibiotic tablets: your general practitioner will need to advise.      See

 

 

Meibomian Cysts (chalazions)

diagram of chalazion

See chalazion. Meibomian cysts (or ‘chalazions’) have different stages. If your eyelid has a small lump in, and is red, painful, and swollen, treat like a stye as above. Meibomian cyst is the name given to a lump in the eyelid; this lump may consist of debris remaining after an infection blocking the gland. Once the main infection has subsided, they do not grow bigger, and are then not very red or painful.

Nearly ally the chalazia/lumps disappear naturally in about 8-16 weeks or a lttle longer. See

chalazion (present a long time)

a chalazion that has been present some time (best having minor surgery)

 

 

The only exceptions are the hard and firm chalazia, and if the lump does not disappear naturally, it can be removed by a small operation in the eye clinic. The doctor injects a little local anaesthetic into the eyelid to make it feel numb.

The cyst is then scrapped out. Sometimes the shell of the cyst is very thick, and the doctor may be able to scrape out the contents, but the shell cannot be removed. If this happens, a small lump may remain in the eyelid. Very occasionally a second operation may help. The operation may cause bruising of the eyelid. If it does, the bruising may take about a week to go. Usually a tiny cut is made on the inside of the eyelid, so there is no scar. If the lump is just under the skin, the doctor may make a tiny cut in the skin.

 

 

acute chalazion, eyemac.com

acute chalazion needing hot bathing and antibiotic cream (possibly tablets as well)

a healing chalazion
a recent acute chalazion: this is likely to settle without surgery

 

 

 

 

 

 

 

 

Recurrent chalazions: prevention

If you develop chalazions quite frequently, preventative treatment may be helpful see. Chalazions may be caused by blockage and infection of the glands in the eyelids. Some people who develop frequent chalazions have dry skin, with secretions blocking the glands.

Treatment that unblocks the glands in the eyelid may help stop more chalazions developing. To prevent the glands blocking, (see blepharitis page):

  1. clean the eyelids each day. Soak some cotton wool in warm water. Rub the cotton wool over the closed eyelids for 2-3 minutes, and repeat.
  2. Then clean the edge of the lower eyelid with a cotton bud to remove scales and debris on the edge of the eyelid. Gently rub the cotton bud along the eyelid, using a mirror, and pulling the lid away from the eyeball with the fingers of the other hand.
  3. It is safer to boil the water first to sterilise it, and allow it to cool.
  4. When the lid is clean after a couple of weeks, It is safe to stop cleaning, but you may need to start again if chalazions start to develop again.
  5. Adding bicarbonate to the water can help. Use a teaspoon of baking soda (sodium bicarbonate) in a pint of boiled water: this solution can be used over a week if refrigerated.
  6. If the cleaning is not helpful preventing the chalazions, antibiotic ointment may help. Your GP will need to prescribe it; try it for 3 months (chloromycetin or fucithalmic).
  7. A healthy diet with omega 3 (or flaxseed oil) and plenty of vegetables and fruit, with little saturated and transfats, is very important.
  8. Sometimes chalazions return once the ointment is stopped, and you may need a repeat prescription from your GP. Some people benefit using the cream intermittently.
  9. Finally, if all else fails and you still develop more chalazions, a course of antibiotic tablets may help, such as doxycycline 50-100mg daily for three months (from your GP). The benefit of antibiotics lasts several months after stopping treatment, but if the condition returns you may need to use further courses.
    This treatment is sometimes useful if the other treatments do not work. It is particularly effective if you have a skin condition, such as acne rosacea, or very dry skin, or if the edge of your eyelid stays red with many scales.
    Antibiotic tablets are NOT suitable for everyone, particularly if you use several other tablets or have stomach problems. You will need to discuss this treatment with your GP first. See excellent article for BMJ subscribers   BJO 2011

 

Cysts of moll

cyst of moll

These are tiny cysts with fluid inside. They do not grow. After a local anaesthetic injection, a small nick is made in the cyst. The skin of the cyst is also removed. Usually they do not recur.

 

Papillomas

eyelid papilloma

Papillomas can grow to different sizes. They are probably caused by a virus, and are essentially warts on the skin.

 

 

eyelid papilloma,eyeatlas.com

They are removed in a ‘minor operations’ clinic in the eye department. Your skin is anaesthetised with a small injection. The papilloma is then cauterised. Usually a little scab forms, and heals in a week, leaving a nearly invisible scar. If the papilloma is near the edge of the eyelid, the scar may make the edge a little crooked. They may recur after the operation, which may need to be repeated.

 

 

 

Download a leaflet

Eye lid lumps leaflet

If you are a health professional and want to have a leaflet to give to give to patients, instead of web pages, this may help. This is a Microsoft Publisher document, and you are welcome to download it and print copies, and make changes for your patients (you can edit the leaflet in Microsoft Publisher).
You will need M Publisher 2000 to open and print the document. M Publisher is often bundled as part of Microsoft Office. The only condition is that you let me know if there are any errors.
It was prepared in 1999 but is still up to date.  It is 1.5mb

Thanks to Gavin Spence for this PDF version

 

Melanoma

 

major features change in size
  irregular shape
  irregular colour
minor features largest diameter =/> 7mm
  inflammation
  oozing
  change in sensation
           lesions with any of the major or three of the minor are suspicious of melanoma BMJ