Skin Cancers Around The Eye

The eyelids are delicate and highly complex structures that are critical in protecting your eyes and supporting vision. They are unfortunately a very common site for skin cancers. 

If you have been diagnosed with a skin cancer on your eyelid or near your eye, it is important to ensure the cancer is removed safely while achieving the best possible functional and cosmetic outcome.

Several types of skin cancer can affect the eyelids and surrounding areas. The majority are basal cell carcinomas, which usually grow locally. Other common types include squamous cell carcinoma and melanoma, both of which have the potential to spread.

While some skin cancers around the eye are relatively straightforward to treat, others are more complex. Successful management requires complete removal of the tumour while carefully preserving eyelid function and the natural appearance of the area.

Successful treatment of skin cancer around the eye requires specialist knowledge of both the eye itself and the delicate surrounding tissues. An ophthalmologist with oculoplastic surgery expertise is uniquely trained to manage eye health while also performing complex reconstructive surgery in this sensitive area.

In some cases, skin cancer around the eye may be treated with non-surgical methods such as radiotherapy, cryotherapy, or topical treatments. Surgery is the most common and effective treatment, and several surgical options are available.

Skin cancer around the eye may be removed using one of the following techniques:

• Wide local excision: The cancer and a margin of surrounding tissue are removed.
• Frozen section surgery: A pathologist examines sections of the tumour during surgery to ensure all cancer has been removed. Once clear margins are confirmed, your surgeon reconstructs the area.
• Mohs surgery: The cancer is removed in stages by a specially trained dermatologist. Thin layers of tissue are examined under a microscope until all cancer is removed. Your surgeon then performs reconstructive surgery on the same day or the following day.

Your doctor will explain all suitable options and recommend the approach that best fits your individual situation.

After the cancer has been removed, reconstruction is essential to restore structure, function, and appearance of the eyelid and surrounding tissues.

 The reconstructive approach depends on:

• The size and location of the defect
• The amount of tissue removed
• The quality of the surrounding skin

Reconstruction techniques may include:

• Direct closure: Closing a small wound with stitches
• Secondary healing (laissez-faire): Allowing small wounds to heal naturally
• Skin grafts or flaps: Using skin from nearby or another part of the body to repair larger defects

Common donor sites for skin grafts include:

• Upper eyelid
• In front of or behind the ear
• Above the collarbone
• Inner upper arm

Often, a combination of techniques is used. In some cases, reconstruction may involve collaboration with other specialists, such as plastic or head and neck surgeons.