Frequently Asked Questions About Eyelid Tumours

• Post-operative bruising and swelling always occurs after eyelid surgery and may last many weeks. Bruising often takes 3-4 weeks to resolve completely, and swelling a little longer. The final result is not seen for at least 3-4 months
• A ‘tight’ appearance to the eyelid. This will settle and become more symmetrical as the swelling subsides and tissues relax.
• Mild blurring of vision may occur for a few weeks afterwards. It is usually helped by blinking.
• Some tearing and mucous discharge is to be expected for a few weeks after surgery.
• The skin wound may start to itch after a few days – this is a sign that the wound is healing.
• Temporary dryness of the eyes may occur after surgery. Blink frequently in order to clear the tear film and keep the eye moist. A short course of lubricating eye drops or gel will be prescribed if necessary.
• The wound is likely to feel uncomfortable for a couple of days. You may take simple analgesia such as paracetamol.

I will advise you on this. However, the following rules generally apply:

• You can read, watch television and go outside (wearing sunglasses if more comfortable) the day after surgery.
• You should resume all medications on the day of surgery, except medicines which may increase the risk of post-operative bleeding. I will discuss this with you on the day of surgery.
• Drive when you feel safe and able to see properly.
• Avoid getting water directly into the wounds when showering or bathing to reduce the risk of infection.
• Do not rub your eye
• Avoid bending for 1 week
• Avoid heavy lifting for 2 weeks
• Avoid eye make-up for 3 weeks
• Avoid dusty environments for 1 week
• Avoid all strenuous activity for 3 weeks
• Avoid swimming for 4 weeks.

Complications in the hands of a trained and experienced oculoplastic surgeon are very rare. However, risks include:

• Infection. This may be heralded by swelling and redness of the wounds and/or increased pain. Should this happen, you must contact the me immediately.
• Scarring. Initially, the incisions will appear red. However, the skin around the eyelids typically heals very well, such that after several weeks most wounds are difficult to see. Generally, less extensive surgery results in less visible scars and better symmetry with the eyelid on the other side of the face.

In most cases the exact cause of a tumour is not known, but factors which are thought to play a role are:

• Exposure to sunlight
• The immune system. Patients on strong drugs which suppress the immune system are at greater risk of developing tumours.

• Inheritance. The genetic influence is complex. It is exceptionally rare for tumours to be inherited directly from a parent.

Distortion of the eyelid, or less commonly, infiltration of the eye socket can cause incomplete eyelid closure, which leads to reduced protection of the cornea (clear ‘window’ at the front of the eye).

In addition, if left untreated for a long time, complete excision can result in a very large defect (and even loss of the eye in rare cases), necessitating more extensive reconstructive surgery. Such extensive surgery sometimes carries a greater risk to the overall protection of the eye.

Many people who have surgery for basal cell carcinomas and very early-stage squamous cell carcinomas will not need any follow-up.

Melanomas, very large tumours or those which have invaded deeply may require follow-up for several years.

Overall cure rates for eyelid tumours are very high – almost 100% in the case of BCCs and SCCs. However, the outlook does depend upon the nature of the tumour and its size and thickness before surgery.

Self-examination and sun protection are highly recommended.

Once you have had a skin cancer, there is a greater risk of developing another one somewhere else. You are also more at risk of developing a recurrence of the skin cancer in the area where you had it before. It is important to regularly check your skin for any new symptoms or changes that could be cancer. Treatment will be much easier and successful if any eyelid tumour is detected early. It is advisable that you should see your doctor if you have any marks on your skin which are growing, bleeding and never completely healing or changing appearance in any way.

Sun Protection Advice:

• Protect your skin with clothing
• Wear a hat that protects your face, neck and ears, and a pair of UV protective sunglasses.
• Spend time in the shade between 11am and 3pm when it’s sunny.
• Step out of the sun before your skin has a chance to redden or burn.
• When choosing a sunscreen look for a high protection SPF (SPF 30 or more) to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA. Apply plenty of sunscreen 15 to 30 minutes before going out in the sun, and reapply every two hours and straight after swimming and towel-drying.