Eyelid lumps are very common and although not usually serious, they can cause considerable discomfort. The two most common types of eyelid lumps are styes and chalazions.
Styes are red and pimply, and occur near the eyelashes at the edge of your eyelid. They are often painful to touch and are usually caused by bacteria infecting an oil gland in your eyelid or an eyelash follicle.
Chalazions are small bumps under the eyelid, which are not usually painful, unless they become infected. Most often, chalazions are caused by the blockage of oil glands in your eyelid.
Both styes and chalazions are more likely to occur if you have blepharitis, which refers to inflammation of the eyelid due to an imbalance between the bacteria normally found around your eyelashes and foreign bacteria or debris.
Blepharitis causes inflammation and crusty eyelids, which blocks the pores and openings of oil glands in your eyelids. These glands secrete oil that contributes to the make-up of your tear fluid.
Other common types of eyelid lumps include xanthelasma and milia. Xanthelasma are fatty lumps under the skin of your eyelids, which are linked to high cholesterol. Milia are tiny white bumps, also known as milk spots, which are more common in children and go away on their own.
Skin tags, warts and papillomas are also fairly common and are usually caused by viruses, including sexually transmitted viruses.
Cancerous eyelid lumps
Eyelid lumps caused by cancer usually behave differently to those more common, noncancerous eyelid lumps mentioned above. They can be red, black, brown or flesh-coloured and may spread. They are often itchy and/or bleed, and notably cause changes in the surrounding tissue.
If they are near your eyelashes, the surrounding eyelashes will disappear. If they are near the edge of your eyelid, your eyelid will swell, notch and thicken, and often become vulnerable to frequent infections, such as a stye that doesn’t heal.
It is important to maintain good eyelid hygiene. This means removing eyelid makeup before you go to bed and keeping your eyelids clean. It can be helpful to work in a routine for your eyelid hygiene by applying a warm towel to your eyelids first thing in the morning and just before bedtime to gently massage and clean them.
If your eyelid lump is distorting your eyeball it can cause vision problems. This is more common with upper eyelid lumps, which can press on the outer clear window of the front of your eyeball (cornea) and cause visual disturbances, such as astigmatism and blurred vision. The severity of the vision problems will depend on the size of your eyelid lump and how much it distorts your eyeball.
If you notice your eyelid lump is growing, bleeding, or there are changes in the surrounding tissue (eg eyelashes disappearing, eyelid notch), it is important to see your GP or optician. You should also seek medical help if your eyelid lump, such as a stye or chalazion, isn’t getting better.
Your optician or GP will examine your eyelid and if appropriate, refer you to an ophthalmologist (a doctor specialising in treating the eyes). It is helpful to keep a photo diary of your eyelid lump to show to your doctor, in case changes occur.
Eyelid lumps do not always need surgery. Chalazions and styes will often get better by applying a warm towel to gently massage your eyelid and keeping it clean. This needs to be done routinely, twice a day, for at least two to four weeks. During this process, it is important to visit your optician or GP, so they can monitor the progress of your eyelid lump as you treat it at home. However, if your eyelid lump doesn’t show signs of improvement and persists, surgery may be needed.
The type of surgery needed will depend on the type of eyelid lump you have. For simple eyelid lumps, local anaesthetic will be applied to numb the area. After the lump has been removed, it will be sent to the lab for further examination and to confirm a diagnosis.
Eyelid lumps, such as chalazions, often do recur and may need further surgery.
After surgery, you will experience swelling and bruising, which will start to improve five to seven days after your surgery. It usually takes one to three months for your appearance to completely return to normal. Most people can return to work after 10 days to two weeks.
Miss Tina Khanam is a Consultant Ophthalmologist at Spire St Anthony’s Hospital, specialising in cataract surgery, lid lump surgery, blepharitis, blepharoplasties, dry eye treatment, red eye treatments, pterygium surgery, keratoconus, refractive surgery and corneal transplants. She has performed over 2,000 ocular surgeries with excellent reviews. She is a Founder and Trustee of The Mannan Foundation Trust, a UK charity supporting disadvantaged children and women. She has been voted the best surgical teacher with outstanding teaching resources. She is also the Co-chair of Homefield Association, a local school charity.