1. Malignant lumps of the eyelid

2. Squamous cell carcinoma
Basal cell carinoma
Squamous cell carcinoma
Sebaceous gland carcinoma
Please notice in the upcoming pictures that Loss of the eyelashes in the vicinity of the tumor always suggests malignancy.

3. Basal cell carinoma The most common malignant tumor of the eye lids.
Mainly in the lower lid.
characteristics:
-painless lesion
- slowly growing
- locally invasive
- without metastasis
- can be: nodular, sclerosing
or ulcerative (rodent ulcer).
treatment:
Complete excision
radiotherapy
- Cryotherapy – less effective
prognosis:
Very good but deep invasive tumors are difficult to treat.

4. Squamous cell carcinoma
Rare
Age older than 50 years
More in Males
Uv light is a risk factor for both Squamous cell Basal cell carcinoma.
also more common on the lower eyelid
characteristics:
- Hard nodule or sclary patch.
- Locally invasive
- Metastasis
- They can arise de novo or from
pre-malignant lesions .
Treatment
- Complete Excision

5. Sebaceous gland carcinoma
very Rare … 0.8% of all lid tumors
Carcinoma of the meibomian and Zeis glands
typically found in women, more often in the seventh decade of life .
usually are on the upper lid margin
Characteristics :
- Highly invasive
- metastasize
may mimic either a recurrent
chalazion or chronic blepharitis
Treatment
- by surgical excision .
Lymph node evaluation is
necessary to evaluate metastasis.
Prognosis
is good with no metastasis, However, sebaceous lesions have a high incidence of recurrence and metastasis

6. This Sebaceous gland carcinoma … masquerading as
Blepharoconjunctivitis.
- don’t forget the loss of eyelashes indicates malignancy !

7. Abnormalities of the lashes
Trichiasis
Distichiasis

8. Trichiasis a common condition
Where the eyelashes will be directed backward towards the glob , against the cornea
It’s distinct from entropion.
Complicated by corneal abrasion
Symptoms : The eye becomes red and irritated
, foreign body sensation, tearing , sensitivity
and sometimes pain when exposed to light

9. Causes : - Infectious : Trachoma, Herpes zoster
- Autoimmune ,Inflammatory
- Postsurgical
Lower lid transconjunctival approach for floor fracture repair or blepharoplasty
After ectropion repair
- Chemical
Alkali burns to the eye
Medical drops (eg, glaucoma drops)
-Thermal burns to face/lids
treatment:
Epilation of the affected eyelashes with electrolysis, cryotherapy .
An underling abnormal lid position is treated surgically

10. Distichiasis
is a rare disorder defined as the abnormal growth of lashes from the orifices of the meibomian glands on the posterior lamella of the tarsal plate
Two types : acquired and congenital.
In the acquired form, most cases involve
the lower lids. Lashes can be fully formed
or very fine, pigmented or nonpigmented
, properly oriented or misdirected.
The congenital form is autosomal dominant
with complete penetrance. It can be isolated
or associated with ptosis, strabismus,
congenital heart defect,
or mandibulofacial dysostosis.
This defect may be related to the epithelial germ cells
failure to differentiate completely to meibomian glands,
instead they become pilosebaceous units, pilo = hair.

12. Instructor : Dr. Arkam By Sofian bni awwad
Thank you
Instructor : Dr. Arkam
By Sofian bni awwad