Nevus at Lower Eyelid Margin Possibly Touching the Cornea - How Should I Proceed? (Photo)

Question

I have a small nevus/papilloma at the medial margin of my left lower eyelid. I previously underwent lower eyelid reconstruction with a hard-palate graft in 2018. The lesion has gradually enlarged, and I am now concerned that it may be contacting the cornea. An oculoplastic surgeon I recently consulted suggested removing only the protruding portion and cauterizing its base, without creating a defect in the eyelid. In your opinion, is this a reasonable approach for a lesion in this location, particularly given the previous hard-palate graft and reconstruction? Would you recommend removal rather than continued observation if it is contacting the cornea?

Serdar Ozates, MD · Answer

Given your previous lower eyelid reconstruction with a hard-palate graft, I would favor addressing the lesion before it enlarges further. If the lesion is gradually increasing in size and is now contacting or irritating the cornea, removal would generally be more reasonable than continued observation.
Considering your surgical history and the location of the lesion, a limited procedure&mdash;removing the protruding portion and carefully cauterizing the base without creating a significant eyelid defect&mdash;may be a reasonable approach, provided that the lesion can be safely treated in this manner.
However, the exact technique should be determined after a careful examination of the lesion, the reconstructed eyelid, and its relationship with the cornea. If there is any clinical suspicion regarding the nature of the lesion, histopathological examination should also be considered.
In your particular situation, the goal should be to remove the lesion while preserving the reconstructed eyelid as much as possible

Nevus at Lower Eyelid Margin Possibly Touching the Cornea - How Should I Proceed? (Photo)

Answers (1)

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