White Bump on the Eyelid

A white bump on the eyelid is likely to be a stye or milia. These usually appear as tiny pimple-like elevations along the eyelid rim or lash line.

Pain in the affected area can be present or absent. They are usually filled with pus or a clear fluid, making it appear whitish or yellowish. Other cases of bumps on the eyelid are often due to bacterial infection or poor hygiene [1].

Different Types of Eyelid Bumps and its Causes

Milia

Picture 1: Milia
Image source: doctorv.ca

• Keratin is a potent protein that is normally present in the integumentary system (eg. hair, skin, and nails). When the keratin becomes clogged beneath the skin, cyst occurs.
• Milia is most often observed among newborns and infants, but adults can have them too. They are typically found on the eyelids, face, and cheeks.
• Children are more likely to develop milia because of their inability to get rid of dead skin. In adults, it is often caused by sunburn or an eyelid trauma [2, 3].

Stye or Sty

 

Picture 2: Stye or sty on the lower eyelid
Image Source: WebMD.

• Stye is a hard white bump inside the eyelid. This is caused by a bacterium called Staphylococcus. Staphylococcus is normally present in the eyelid in small number. Even so, the growth of the bacteria can be out of hand, leading the bacteria to attack the oil glands.
• As the infection sets in, the area becomes tender, red, and swollen. A white bump right at the center then starts to form and this becomes filled with pus.
• Stye is caused by blocking of oil glands at the base of the eyelash. It is experienced in all age groups but particularly common among teenagers. It is triggered by rubbing of the eyes with unclean hands, poor nutrition, lack of proper hygiene, dehydration, and sleep deprivation [3, 4].

Chalazion

Picture 3: Chalazion on the upper eyelid
Image source: Wikipedia.

• Chalazion is a white spot on the lower eyelid formed by an inflammation and obstruction of the sebaceous gland. It can be categorized as superficial or deep, depending on what glands are blocked.
• Deep chalazion is formed by the Meibomian gland whereas superficial chalazion is formed by the Zeis gland. Deep chalazion is more common than superficial chalazion because more often than not, it is the Meibomian gland that gets blocked.
• It is also associated with poor hygiene, viral infection, immunodeficiency, carcinoma, and tuberculosis [5, 6].

Xanthelasma

 

Picture 4: Xanthelasma
Image source: HxBenefit.

Xanthelasma refers to yellow hard patches on the corner of the eyelids. It can also be soft and semisolid, and is a typical sign of aging. It is not that painful, but if it is, it could be a sign that you are at a higher risk to develop heart disease. You are more likely to get xanthelasma if you have dyslipidemia (abnormal lipid levels in the blood) and liver cirrhosis [7].

Papilloma

 

Picture 5: Eyelid Papilloma
Image source: MOOR Eye Care. Available from:
http://mooreyecare.co.uk/medical-eye-diseases/lumps-and-bumps-on-the-eye-lid/

Papilloma usually occurs among middle aged or elderly patients. It is a pink or skin tone bump on the eyelid that is painless and benign or non-cancerous. Papilloma is caused by a virus or warts. Although they are painless, it is aesthetically disturbing that is why other people opt to remove this. Other papillomas might enlarge enough to cause impairment of vision [3, 8].

Cyst

Cysts are almost always benign. However, it could also cause visual impairment. Eyelid cysts are caused by poor hygiene, cosmetics, dirty contact lenses, gland blockage, or rubbing of the eyes with unclean hands [3, 9].

Allergies

 

Picture 6: Eyelid rashes/allergies
Image source: New Health Guide.

• Allergy as the cause of white bump on the eyelid is a diagnosis of exclusion, meaning when all else fail to explain the presence of this white bump, allergy comes into picture especially when the patient’s history reveal the use of cosmetics or chemicals. Get rid of these and the white bumps will go away on its own [3].
• There is a wide range of possibilities for the causes of white bumps on the eyelid. If the glands stop producing oils, the eyes will get dry, and dryness can lead to bumps.
• Dermatitis, psoriasis, conjunctivitis, cellulitis, and bacterial infection are among the differential diagnoses that can cause bumps.
• If a white bump on your eyelid won’t go away for months, consult your dermatologist. Ruling out malignancy is important in the workup.

Treatment

Oftentimes, white bumps on the eyelid go away on its own even without treatment. But if you want to get rid of it faster, here are some tips.

Home Care

• Contact of the hands to the eyes to bare minimum is important to maintain. If needed, make sure to perform proper handwashing before touching or rubbing your eyes.
• Observe proper hygiene measures in using contact lenses.
• Makeups and other cosmetics should never be shared to others.
• Apply washcloth soaked in water on the affected eyelid. It must be applied 5 minutes for 4 to 6 times a day. This remedy will reduce the pain and shrink the white bump.
• Do not squeeze or pop a stye or chalazion. This can increase the risk for infection and this can also spread bacteria to the other eye [10].

Medical and Surgical Treatment

• Antibiotic eyedrops or ointments may be prescribed if a bacterial infection is suspected to be present.
• If the stye appears frequently for months, the physician may prescribe an antibiotic cream to inhibit continual onset.
• Medications for other eyelid bumps like milia include topical retinoids that contain Vitamin A. Also, surgical processes may be applied like diathermy, destruction curettage, or deroofing.
• Other eyelid bump like papilloma may also require surgical excision.
• To decrease inflammation, injection of a steroid medicine in the area of the bump may be needed [11, 12].

References

1. White Bump on the Eyelid. : http://www.treatcurefast.com/bumps/white-bumps/white-bump-on-eyelid-small-spot-on-eyelid-under-inside-hard-lower-rim-cyst/
2. Milium Cyst. : http://www.healthline.com/health/milia#Overview1
3. White Bump on the Eyelid. :http://www.med-health.net/Pimple-On-Eyelid.html
4. Stye. : https://en.wikipedia.org/wiki/Stye
5. Chalazion. :http://emedicine.medscape.com/article/1212709-overview
6. Chalazion etiology. :http://emedicine.medscape.com/article/1212709-overview#a4
7. Xanthelesma. :http://www.webmd.com/eye-health/xanthelasma
8. Eyelid lumps. :http://www.goodhopeeyeclinic.org.uk/lidlumps.htm
9. Eyelid cysts. :http://www.eyehealthweb.com/eyelid-cyst/
10. http://mrdoctor.org/white-bump-on-eyelid-causes-and-treatment/
11. Milium Cyst. http://www.healthline.com/health/milia#Treatment5
12. Chalazion. Available from: http://www.emedicinehealth.com/chalazion_lump_in_eyelid/page3_em.htm