Although the eyelid is designed to protect the eye, its skin is exceedingly thin and contains many fragile tissues that may be injured by UV light. Inside the eye, the lens and the cornea, both transparent, filter UV rays, but by doing so for many years, they may become damaged. This is especially true for the lens, which through years of UV absorption, turns yellowish and cataractous. The lens is the eye’s transparent focusing mechanism, located between the iris and the vitreous humor (the clear, thick gel in the posterior compartment of the eye that fills the space between the lens and retina, giving the eye its form and shape). The cornea, the transparent area in front at the outer layer of the eye, admits light and images to the retina. UV damage is instrumental in causing:

Eyelid cancers: Skin cancers of the eyelid, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) as well as melanoma, account for 5 to 10 percent of all skin cancers. Most occur on the lower lid, which receives the most sun exposure. Basal cell carcinomas make up about 90 percent and squamous cell carcinomas 5 percent or more of all eyelid cancers, while melanomas account for about 1-2 percent. basal cell carcinomas of the eyelid affect an estimated 16.9 men and 12.4 women per 100,000 people in the U.S. each year, and while basal cell carcinomas elsewhere on the body rarely spread, eyelid basal cell carcinomas have a significant risk of spreading to the eye itself and surrounding areas, causing major damage to the eye and disfigurement to the face.

Squamous cell carcinomas have a faster growth rate and a greater potential to spread. Both of these types of cancer are found mainly in patients with a history of sun exposure. Melanoma can spread rapidly in the eye area and can prove lethal if not treated promptly. Melanomas have been linked to a history of intense, intermittent sun exposure and sunburns.

When diagnosed and treated early, eyelid cancers usually respond well to surgery and follow-up care, with the eye and eyelid largely retaining normal function. With reconstruction, they generally remain cosmetically attractive. But left untreated, they are extremely dangerous and may even ultimately penetrate the brain. Watch for these early warning signs:

• a lump or bump that frequently bleeds or does not disappear
• persistent red eye or inflammation of the eyelids that does not respond to medication
• newly acquired flat or elevated pigmented lesions that have irregular borders and growth
• unexplained loss of eyelashes

If you have any of these warning signals, consult a skin cancer specialist or ophthalmologist, even if you feel no discomfort.

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