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Bump on the eyelid: Most common things in Colorado

Many patients come to my office in Denver with a bump on or near their eyelid asking me "What is this?" Here are the three most common causes of a bump on the eyelid that I see. Each one is treated differently and should be checked out by a doctor. As an eyelid specialist I often see several of these patients each day. Here are the three most common things I see in my clinic:

  1. Benign Eyelid Cyst

  2. Chalazion or Stye

  3. Basal Cell Cancer

Benign Cyst

A benign cyst is a non cancerous growth on the eyelid. A cyst is a liquid filled sac. These are extremely common and show up on the eyelid edge or near the eyelid edge. A benign cyst usually develops slowly and grows slowly. There is no pain associated with them.

I remove these growths in the office and send them to the pathologist to analyze. The risk of what I think is a benign cyst turning out to be a cancer is roughly 2% as studied by Kersten et al. who found that oculoplastic surgeons are wrong 2% of the time when the doctor tries to predict before pathology analysis whether something is benign or cancerous. Sometimes care must be taken when excising a cyst near the tear duct to prevent damage to it.

Chalazion or Stye

A chalazion or stye is a blockage of the oil gland. It is a benign or non cancerous growth of the eyelid that is caused by a blockage of the oil gland. It often starts as a painful bump on the eyelid with redness and swelling. Often it is confused for an infection of the eyelid. A chalazion or stye responds most often to warm compresses four times a day for a month. If that doesn’t work then I lance the stye in the office which takes care of them 95% of the time.

Basal Cell Carcinoma

A basal cell carcinoma is the most common type of eyelid cancer I see in my office. Basal cell carcinomas are very common in Denver and often ignored by patients who believe them to be benign growths.

Characteristics of Basal Cell Carcinoma are:

Loss of eyelashes

Spontaneous Bleeding

No pain

Destruction of eyelid edge

Basal cell carcinoma of the eyelid needs to be removed. I usually perform these cases with a Mohs surgeon who can remove the cancer after which I reconstruct the eyelid. If the cancer is allowed to grow it can invade the orbit or eye socket. Fortunately this is rare in Colorado though I have had a couple of patients who have let it go to that level and needed their whole eye socket removed. That is a suboptimal outcome for something that if treated earlier would be a simple procedure to remove the cancer.

I hope this helps Denver patients with eyelid growths know what the big three things are that are seen on the eyelid. A skin cancer is like a parking ticket. If you observe it, it never goes away but only grows bigger and bigger (sort of like a parking

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