Eyelid lumps

These, obviously, include the usual list of benign/malignant skin lumps, plus xanthelasma, which I already know. The list below is to clarify some that I wasn’t sure of.

Chalazion: blocked meibomian gland.

Internal hordeolum: infected chalazion.

External hordeolum: infected hair follicle.

Stye: another term for external hordeolum.

Cyst of Moll: a cyst arising from a blocked sweat gland.


Red flags:

  • Distortion of the lid margin
  • Local loss, or whitening, of lashes
  • Lumps that appear to be chalazia but keep recurring in the same position.
  • Skin ulceration/bleeding
  • Diplopia (can indicate orbital invasion)
  • Proptosis (ditto)

Treatment of benign lumps: Persistent chalazia and cysts of Moll can be excised, although whether the NHS will pay for this in the absence of sinister features is of course another matter entirely. Small chalazia, and hordeola, can be treated with warm compresses. The role of topical antibiotics in treating hordeola is debatable, but oral antibiotics should be used if there is an associated cellulitis.

(BMJ 2014;348:g3029)

Added, from Pulse on-line learning module:

Conjunctival concretions/lithiasis: A mixture of conjunctival secretions and the degenerative products of epithelial cells. Form small yellowish-white nodules in the conjunctiva. Extremely common and usually harmless, but occasionally can cause corneal abrasions/foreign body sensation, in which case need referral. More common in patients with dry eyes/blepharitis, and also in patients on dialysis (due to calcium deposition).


About Dr Sarah

I'm a GP with a husband and two young children.
This entry was posted in Credits 2014, Lumps and Bumps, Ophthalmology. Bookmark the permalink.

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