What is it?
Eyelids tumours are skin neoplasms, which may be of either benign or malignant nature. Appearance of any tumours on eyelids should be a sign to visit a specialist. One should also not ignore recurrent lesions at the site where treatment had been performed. Malignant nature of skin tumour may be indicated by:
An initial diagnosis is made with the use of a slit lamp. Very often, however, a physical examination is not sufficient to make a final diagnosis, since skin lesions often show similar gross appearance, despite different histopathological structure. For this reason, a biopsy of the lesion is performed. Biopsy with complete lesion resection answers the question about the tumour nature, at the same time removing neoplastic cells. Small tumours located far from the lacrimal point, tumours of the lateral canthus, tumours not covering the margin of eyelids or located in their centre typically qualify for biopsy.
Surgical excision is a treatment of choice in any type of basal cell carcinoma, squamous cell carcinoma with precancerous lesions, and melanoma. It ensures the biggest chance of complete recovery and lack of recurrence. It ensures better cosmetic effects and shorter patient convalescence time. The procedure may be conducted in two ways:
- removal of tumour and excision of 1-2 mm thick strips from surrounding tissues, which are checked until clear surgical margins, i.e. strips without neoplastic cells, are obtained;
- excision of tumour with wide margins of surrounding tissues, which is used when the neoplasm is located in the region of the medial canthus, as well as in the vertical line of the mid portion of the face, where there is the highest risk of deep tissue infiltration.
The procedure is followed by reconstruction of the site after tumour removal. The reconstruction should be performed quite soon, but following a histopathological examination to make sure that the neoplasm had been excised in whole. In the case of small defects located in the region of the medial canthus, the tissues may be left for spontaneous healing (granulation), which also gives good cosmetic effects, but requires long months of healing.
With larger defects, which usually cover a much wider eyelid area than the visible tumour, the reconstruction procedure is necessary. For tissue reconstruction in full thickness eyelid defects, the following principles are applied.
- in small defects (up to 1/3 length of the eyelash margin), a direct, simple tissue suturing is performed;
- in larger defects with flaccid skin, lateral ligaments are incised (lateral cantholysis), especially when the defect is located in the central or lateral part of the eyelid.
- in large defects, various surgical techniques are combined with performance of e.g. skin flap and free tissue graft. With such procedures, the methods using Tenzel, Mustarde, Hughes or Cutler-Beard bridge flap are recommended. The last two techniques are carried out in two stages. In stage two, after about 3 weeks, the sutured eyelids are released;
After the procedure, a dressing and ointments with antibiotic are applied. Skin sutures are removed after 7-10 days, and absorbable sutures are left for spontaneous absorption. Patients with malignant neoplasms require regular check-up examinations for at least 5 years after surgical treatment.
FAQ
During a basic ophthalmological visit, the patient’s ophthalmological history is taken, and the following examinations are conducted: autorefraction, keratometry, intraocular pressure measurement, visual acuity examination, slit lamp examination and fundoscopic examination.
In most cases, yes. If the doctor decides that some additional examinations are necessary, they may be performed during the visit, or if the doctor does not perform that kind of examinations, the patient is referred to another specialist.
An ophthalmological visit with performance of basic examinations lasts about 20 minutes. In some Centres, the examinations being part of the visit are performed by auxiliary personnel in the examination room. These activities are also included in the time of the basic visit.
Yes, it is recommended that contact lenses be removed before the visit. The patient should bring the lenses to the visit, since the doctor may ask the patient to insert them.
The cost of a visit is as per the price list on our website.
The waiting time for a private visit is up to a week. This time may be longer if the patient wants to see a particular specialist. The waiting time for a National Health Fund visit is according to the waiting list. Please call or e-mail us to appoint a specific date.
Yes, but you should inform the doctor that you would like to select glasses or lenses at the beginning of the visit.
Yes, you should normally apply your eye drops.
An ophthalmological visit does not require special preparation. If this is your first visit at the centre, you should have the identity card, which is necessary to create a patient record. Also remember that in most cases it is not allowed to drive a car after an ophthalmological visit.
During the first visit, the doctor takes the patient’s ophthalmological history. If the patient has any ophthalmological documentation from other institutions, it is worth taking it to the visit.
You can return to work/school after the ophthalmological visit, but please remember that if you received eye drops at the visit, your vision may be disturbed and blurred for about 2-3 hours.
Ophthalmological check-ups is an individual matter. The doctor usually informs the patient during the visit when he/she should return. Patients over 50 should have a check-up at least once a year.
If you received pupil-dilating drops at the visit, you must NOT drive a car directly after the visit. You should wait for about 2-3 hours.