Common and clinically important eyelid lesions

Eyelid lesions can disfigure, disable and kill, although most are innocent. This article outlines an approach to eyelid lesions.

Recognition of lesions that occur around the eyes requires a depth of clinical experience. Even with good experience, there is a significant rate of incorrect identification of significant lesions. A delay in management of nonmelanoma skin cancer may have impacts on the lesion size and the difficulty of adequate clearance and satisfactory reconstruction (i.e. the closure of the defect with minimal long-term impact on visual function or aesthetic concerns). A delay may also lead to orbital or intracranial invasion, with loss of the eye to achieve clearance of disease in the first instance and possible loss of life in the second instance. Metastasis may occur in melanoma, rarely in common nonmelanoma tumours (e.g. squamous cell carcinoma; SCC), and relatively commonly in rare nonmelanoma tumours. This may lead to reduced life expectancy.