Beware of bumpy eyelids

 

Sometime last year, I developed a small bump almost in the center of my lower right eyelid (see selfie above). At the time I thought, "Damn. I'm getting a stye, and I HATE styes!" I was so sure it was going to turn into a stye that I checked my medicine cabinet to be sure I had some ointment specifically for treating styes, which I did. 

 

But it never turned into a stye. It didn't get red, or sore. It was just this tiny pearly bump, right on the surface of the eyelid, almost at the center. When it didn't turn into a stye, I thought maybe it was a blocked Meibomian gland. Can you tell I worked with a bunch of ophthalmologists at an eyecare company for 10 years?

Being fair skinned and living in Texas, I have a standing annual appointment for a full body check for skin cancer every December. It's supposedly a "thorough" skin check. The PA even goes through the hair on my head, to examine my scalp. But she's never examined my eyelids and I didn't call her attention to the bump at that visit, so she didn't notice it. I've since read that a thorough skin cancer check should always include careful examination of the eyelids, which are a common site for skin cancers. 

 

In early February, two months after my annual visit, when the bump still hadn't gone away, like all bad patients I looked it up on the internet and learned it could be skin cancer. "Nah", I thought, "no way!" But to be on the safe side, I called the dermatologist's office and made another appointment. At that visit, on February 26th, I mentioned that I was worried it might be skin cancer. The PA scraped the bump. She did not take tissue for a biopsy, but said she didn't believe it was skin cancer, but thought it was some sort of milia cyst. She sent me home with instructions to treat it with warm compresses, assuring me it would go away.

I did as instructed. But it didn't go away. And my eyelashes stopped growing in that area. And if you looked at it closely, in a 10x magnifying mirror, like I did at least once every day, you could see a rather fierce looking, spidery red blood vessel, like a flower stalk, going to the center of it. 

 

So in early July I called to make another appointment. Asked for the reason for the appointment, I told the receptionist that a bump on my eyelid for which I'd been seen in February hadn't gone away, had in fact grown, and that I believed it might be skin cancer. None of which impressed the receptionist. Mid-August was the first available, she said. I took it. 

 

At the August appointment, which was on a Monday, the PA examined the bump again. This time, she noticed the missing eyelashes and the blood vessel, two tell-tale signs of BCC. She measured the bump and said it's 3 mm across (tiny, right?). But she looked rather somber when she said, "This appears to be a BCC (basal cell carcinoma)". She referred me to an oculoplastic surgeon, and then, brightening up, she said cheerfully, "He'll remove it and put in a couple of stitches", leading me to believe this was no big deal. She did say if I hadn't heard from the oculoplastic surgeon's office by Friday, I should call them. She also said if they couldn't see me right away, I should come back to the dermatologist to have it removed.

Uh huh.

On Friday, not having heard from the oculoplastic surgeon's office, I called them. They told me the reason they hadn't contacted me was simple: they hadn't received the referral. In fact, they hadn't received any referrals at all that week from my dermatologist's office. The woman who took my info was very nice. She said, "The way it works is your dermatologist will remove the BCC, and then you'll see the surgeon for reconstruction of your eyelid." That was the first time I'd heard the word "reconstruction" regarding any of this. It sounded rather ominous, but also, that was not what I'd been told, and I said so. I told her that the PA had told me that the oculoplastic surgeon would remove the BCC and repair the eyelid. She paused for a moment and then said, "OK. Well, that means it's either too big, or in too critical a location for the dermatologist to remove it. But don't worry. Dr. A does this all the time. You're in good hands here." First available appointment was second week in September. Needless to say, I took it.

 

To be continued.