Benign tumours, even though benign, often require removal and therefore must be examined carefully and the differential diagnosis of a malignant eyelid tumour considered and the method of removal planned. The lesion is examined with respect to its size, shape, colour, level in the eyelid, mobility, tethering and tenderness. The peri-orbital area is examined for additional lesions.
If a malignant tumour is suspected, full medical examination is performed and the oculoplastic surgeon works together with the dermatologist, oncologist and head and neck surgeon.
The majority of small lumps and bumps around the eyelids are benign and can be easily removed in their entirety. However, even a benign looking lump can be a tumour masquerading as benign and the cells have to be analysed under the microscope to exclude a malignant tumour (histopathological analysis).
The treatment of eyelid lesions depends on the diagnosis which is obtained by biopsy. Benign eyelid lesions are excised in full and ocular reconstruction performed using direct closure, flaps or grafts.
Malignant tumours may require adjuvant treatment with either radiotherapy or chemotherapy after excision, depending on their diagnosis.
Surgery of eyelid lumps and bumps can frequently be done under local anaesthetic, with the surgeon assisted by magnification, in the form of surgical loops worn on spectacles, in order to place very fine stitches which are almost invisible.
The result of the histological analysis (examination of the cells) is usually available within a week.