Benign growths on the eyelid and eye are quite common. Although they are not cancerous, these growths—sometimes known as tumors—can become uncomfortable or interfere with eyelid function. In other cases, they can cause vision problems. 

If a growth isn’t bothersome, there is no medical need to remove it, although some people may opt to remove benign growths for cosmetic reasons.

At Yale Medicine, our specialists use cutting-edge, evidence-based medical and surgical techniques to optimize the outcomes for all of our patients.

Commonly referred to as styes, chalazions—clogged glands on the upper or lower eyelid—are the most common benign growths, according to oculoplastic surgeon Michael S. Ehrlich, MD, a Yale Medicine ocuplastic surgeon and assistant professor of Ophthalmology and Visual Science at Yale School of Medicine. 

They can become inflamed or infected, and they frequently require treatment. Most chalazions form when a sebaceous gland, which produces the oily film that prevents tears from evaporating, becomes clogged.

Another common benign eyelid growth is a papilloma. Although these wart-like growths are painless, papillomas can become bothersome if they become too large or are too close to the edge of the eyelid.

Nevi, or freckles, can appear anywhere on the body, including the eyelid or the eye. “Like freckles anywhere on your body, nevi on or around the eye should be checked to make sure that they are not changing and becoming skin cancer,” Dr. Ehrlich says. When nevi are benign, though, they rarely affect vision.

Chalazions can become red, irritated, swollen and painful. People with chalazions may feel as if there is something in their eye. If there is significant swelling or the chalazion is on the edge of the eyelid, vision can be affected.

Nevi are characteristically pigmented but painless. Papillomas can be itchy, and larger ones can become uncomfortable. Depending on where they are on the eyelid, papillomas can also interfere with vision.

Chalazions are more common as we get older and may be associated with changes in the variety of normal healthy bacteria on the skin, which can block the sebacious glands.

Nevi are often related to sun exposure, especially on the eyelids. Exposure to tobacco is another cause. Rare genetic diseases can also contribute to risk of developing nevi.

Papillomas are caused by the human papilloma virus. “Frequently, papillomas can’t be traced to any specific exposure,” says Dr. Ehrlich. 

Chalazions may resolve on their own or through home treatment with warm compresses.

If they do not go away within a few weeks, or if they are becoming more bothersome, chalazions can often be successfully treated with a combination of antibiotics and steroids, in either ointment or eye drops.

In certain cases, chalazions may be treated using an injectable medication. “If the chalazion does not respond to medication, we may perform a small surgical procedure in the office to remove the inflamed tissue,” says Dr. Ehrlich.

Although nevi are generally harmless, they may be removed for aesthetic reasons. Nevi can be excised during an office visit. After the area is numbed, the nevus is removed and then the edges of the incision are shaved to create a smooth-appearing, functional eyelid.

Papillomas are usually simply observed and monitored if they are not bothersome. But papillomas that grow and affect vision or comfort can usually be easily removed in an office procedure.

“Pingueculas and pterygia are among the most common benign growths on the surface of the eye,” says Jessica H. Chow, MD, a Yale Medicine ophthalmologist. 

A pinguecula appears as a yellow patch on the conjunctiva (the white part of the eye). A pterygium (sometimes referred to as surfer’s eye) is a pink, fleshy growth that starts on the conjunctiva but usually extends on to the cornea (the clear, dome-shaped “window” at the front of the eye). Pterygia frequently develop from pingueculas.

Pingueculas and pterygia are caused by exposure to sun, ultraviolet light and wind.

Benign, fluid-filled cysts can also be found on the conjunctiva. These conjunctival cysts can result from earlier surgery or trauma, or they can just appear. Sometimes, depending on the size and elevation of the cyst, it can become irritated by movement of the eyelid.

Most tumors can be diagnosed by the ophthalmologist based on the appearance of the growth and its history. When the diagnosis isn’t certain, the ophthalmologist will either consult with another physician—often a dermatologist—or send a sample of the growth to be examined by a pathologist.

In most cases, a pterygium that is removed is sent to the lab to be analyzed, just to be certain that it is benign.

“Typically, we don’t operate on a pinguecula,” says Dr. Chow. “But we will remove a pterygium if it presses on the cornea and causes an astigmatism (an irregularity in the shape of the cornea), if it grows into the center of the cornea and interferes with vision or if it causes irritation just because of its size and location.”

Pterygia are removed during an outpatient procedure in which the ophthalmologist uses a blade to scrape the growth off of the surface of the eye. To prevent the growth from recurring before the conjunctiva has had time to heal, the ophthalmologist usually covers the affected area with a graft – either a piece of conjunctiva from the patient’s eye or a piece of amniotic membrane that was harvested and donated after birth.

The amniotic membrane grafts are eventually replaced by the patient’s conjunctiva.

Cysts, though, are usually not removed. “Benign cysts frequently recur after they are removed surgically,” Dr. Chow says, “so if they are not bothersome, we frequently leave them alone.”

“As a tertiary care center, we see these conditions very frequently,” says Dr. Ehrlich. “We are very experienced in diagnosing and managing growths that appear in and around the eye.”

Tertiary care, practiced by Yale Medicine, is a highly specialized form of care for patients whose conditions may be too complicated for a typical medical practice to treat.