Not a Stye: A Rapid-Growing Eyelid Lesion Near the Tear Duct

A 27-year-old male patient was referred to me by his primary care doctor for evaluation of a lesion on his right lower eyelid. It had grown rapidly over the past few weeks. The patient had a history of non-Hodgkin’s lymphoma 12 years ago, but has been in good health since.

He had experienced small styes in the past — all of which responded well to warm compresses — but this one looked and behaved differently. It was larger, faster-growing, and located very close to the tear duct.

When a Lesion Isn’t a Stye

On examination, I immediately knew this was not a stye. The lesion appeared more consistent with a benign skin growth — likely a papilloma or a form of keratosis. These types of growths are commonly seen on the thin skin of the eyelids or neck. While often described as viral in origin, they generally arise randomly and are not caused by anything the patient does.

Still, given this patient’s history of lymphoma, I took his case seriously. While he had no current symptoms of immune dysfunction and no other infections, I considered the possibility that his immune system could be playing a subtle role.

Lesion Location Matters

Importantly, the lesion was situated very close to the tear duct. Growths in this area require careful evaluation, because involvement of the lacrimal drainage system can lead to serious complications. Fortunately, in this case, the lesion was clearly isolated and not connected to the duct.

His vision and ocular surface were completely normal.

Treatment and Removal

After a full exam and patient discussion, we proceeded with surgical excision in the office. The area was numbed with a small injection of lidocaine, and the lesion was removed using fine surgical scissors. Despite the lesion’s large size, it was attached to the skin by a very narrow stalk containing a small blood vessel.

As expected, there was a small amount of bleeding, which is common with this type of removal. I applied light thermal cautery to the base, and the bleeding stopped immediately.

Here’s a short video of the procedure:

 

 

Pathology and Aftercare

The lesion was sent to pathology and confirmed to be a benign papilloma — no cancer or precancerous changes. The patient was relieved and recovered very well. He was prescribed a few days of antibiotic-steroid drops to promote healing and reduce inflammation. Discomfort was minimal.

Final Thoughts

Not every eyelid bump is a stye — especially when it grows quickly, doesn’t respond to compresses, or appears near sensitive structures like the tear duct.

If you or someone you know has an eyelid lesion that’s new, changing, or just doesn’t look right — get it evaluated by a specialist. Early diagnosis can prevent complications, and in many cases, the treatment is quick and straightforward.