Eyelid Cancer Be On the Lookout

By Orin Zwick, MD

Chesapeake Eye Care & Laser Center

. https://www.chesapeakeeyecare.com/

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Eyelid Cancer Be On the Lookout

The eyelids are a very specialized part of our bodies. They help to keep the eyes lubricated and protect the eyes from injury by constantly blinking. Like the heart that constantly pumps blood and keeps us ticking, the eyelids provide a vital function without us even thinking about it. However, when something goes wrong with the eyelids, it can wreak havoc by causing improper closure, drying out of the eye surface causing pain and irritation, possibly even leading to infection and blindness.

There are many different types of growths, which can occur on the eyelids, ranging from benign, inflammatory lesions to malignant cancer. Early detection and surveillance is the key to identifying a cancer on the eyelid and addressing it early, before the damage becomes devastating. The proper excision and repair of an eyelid lesion ensures that eyelid function remains intact.

Just like anywhere else on the skin of our bodies, we can develop growths on the eyelids. Examples of benign growths on the eyelids include styes, cysts, moles, skin tags and seborrheic keratoses. Many of us are aware of a stye, a small, red bump at the eyelashes, which is tender and usually goes away with warm compresses. However, larger inflamed growths called chalazia can form if the oil-secreting glands of the eyelids continue to stay blocked.

Eyelid cancers are typically painless, but can slowly destroy the normal architecture of the lid. The majority of eyelid cancers are basal cell carcinoma, but occasionally they can be a squamous cell carcinoma, sebaceous cell carcinoma, and rarely a melanoma. Concern for cancer usually arises when a lesion grows, causes loss of eyelashes, or just doesn't go away.

When a cancer is identified on an eyelid, usually through biopsy, there are three primary goals. First, the cancer must be removed in its entirety, usually with frozen section margins. This means that under microscopic evaluation, the borders around the lesion must be completely free of cancer. This is important since most eyelid cancers are locally aggressive but do not spread elsewhere.

Once the cancer is removed, the reconstructive effort begins. Repair of an eyelid depends on the size of the defect, the location, and the laxity or stretch of the remaining tissue. There are different options for repair, but all focus on the next two goals function and cosmesis. This means the repair must allow the eyelids to function properly to close and blink to keep the eye comfortable and protected. Since the eyelids and eyes are the primary focus point when communicating with others, it is of utmost importance to keep the appearance as symmetric as possible to the opposite eye. As an oculoplastic surgeon who specializes in eyelids, I can't stress enough the importance of being on the lookout and having a consultation for any eyelid lesion that raises concern.