Worried about lumps and bumps?
LOOKING into a mirror, you might notice a small bump on your eyelid. You dismiss it, thinking it not worth the time to go to the doctor to get it checked out. However, Dr Nazila Ahmad Azli, consultant ophthalmologist and oculoplastic, lacrimal and orbital surgeon at Ara Damansara Medical Centre, thinks otherwise.
Dr Nazila says 80% of all abnormal growths on the eyelid are benign, and malignant growths are not common in Malaysia. However, she asserts, “It is important for the public to be aware and know how to differentiate between malignant and benign growths so they can seek treatment earlier.”
She says some common causes for benign eyelid growth include infection of the lash follicles, which causes a stye and clogging of the eyelid’s oil glands, which causes a chalazion.
Dr Nazila says recurrent chalazia could be a marker to a more sinister lesion. “When a chalazion recurs even after treatment, there is a large possibility that it is a sebaceous gland carcinoma, as both conditions affect the same eyelid gland.”
For malignant abnormal eyelid growths, Dr Nazila says basal cell carcinoma takes up 90% of all malignant occurrences worldwide. The bump most commonly appears in the lower eyelid, but it can occur elsewhere around the eyelid. Risk is increased with age and excessive exposure to ultraviolet (UV) light. Individuals with fair skin are also at risk.
Other types of eyelid cancer include squamous cell carcinoma, sebaceous cell carcinoma and malignant melanoma.
Both types of growths may interfere with the patient’s life, causing blurred vision, eyeball compression, astigmatism and general discomfort.
Early treatment can yield good results
If eyelid cancer is allowed to advance, it can cause eyelid and facial disfigurement. Dr Nazila, however, offers good news, saying, “Eyelid cancers rarely metastasise although they can be locally invasive. The prognosis is also very good when detected early.”
With early diagnosis, treatment is fairly simple. Dr Nazila illustrates the usual process of either incisional biopsy or excision biopsy coupled with eyelid reconstruction. She says, “When we carry out a biopsy of the eyelid, we also take a good amount of normal tissue around the growth to ensure all malignant cells are removed from the body.”
Other treatment options are Mohs micrographic surgery, frozen section technique excision, radiotherapy and chemotherapy, depending on the stage and severity of the disease.
Clean lids, clear vision
“Malignant eyelid growth risk factors depend on your age, family history, exposure to UV rays and previous malignoma. Farmers and fishermen, for example, are more likely to have malignant eyelid growths. People living in sunexposed countries, such as Australia, have heightened risks, too.”
Dr Nazila stresses that eyelid hygiene is important to halt benign eyelid growths, as problems normally arise from dirty lashes. “We are exposed to dust every day, and we expose our eyes to cosmetics that clog up the oil glands of the lids. This allows for the excess growth of bacteria that are normally present on the skin.”
Her advice is to clean your eyelids at least twice a day with a warm towel or lid wipes to clear the debris from our eyelids. In addition, warm compresses on the eyes can also improve the oil flow from clogged glands.
Eyelid cancers rarely metastasise although it can be locally invasive. The prognosis is also very good when detected early.