A problem that requires expert care

The eyelids are delicate and complex structures that perform essential functions. They are also important to your appearance.

If you’ve been diagnosed with a skin cancer on your eyelid or near your eye, you’ll want to ensure that it’s safely removed while giving you the best possible functional and aesthetic result.

There are several types of skin cancer that affect the eyelid and area around the eye. The vast majority of skin cancers are basal cell carcinomas. Other common ones are squamous cell carcinoma and melanoma.

Squamous cell carcinoma and melanoma can spread.

While some cancers around the eye are relatively simple to manage, others are complex. It is essential to remove all of the tumour while preserving the function of the eyelid and the appearance of the area.

Why choose an ophthalmologist with oculoplastic surgery expertise?

Successful treatment of skin cancer around the eye requires an ability to assess and manage the eye as well as deal with the soft tissues in this area. A ophthalmologist with oculoplastic surgery expertise is uniquely trained to address all the issues you will face.

Other practitioners including plastic surgeons, head and neck surgeons, dermatologists and GPs with an interest in skin cancer are not specifically trained in dealing with the eye.

When you first visit Dr Parker, he will be able to advise you on the most effective approach to treatment. If your case is complex, he may involve a multidisciplinary team with other health care professionals to ensure that you get the best possible outcome.

How is skin cancer around the eye treated?

There are only a few situations where skin cancer around the eye is treated with radiotherapy, cryotherapy or topical treatment. Surgery is the most widely-used treatment and there are different types of surgery available:

Surgical approaches to removal

Ways of removing skin cancer around the eye include:

  • Wide local excision where the cancer and an area around the margin are removed.
  • Frozen section where a pathologist checks each section of the tumour while the surgery is being performed. When all the cancer is removed, Dr Parker reconstructs the area.
  • Moh’s surgery where the cancer is first removed by a specially-trained dermatologist in their operating theatre. Thin layers of skin containing the tumour are removed one at a time. Each layer is examined with a microscope to identify the type of cancer and to check if any cancer remains. The dermatologist keeps removing skin layers until all the cancer has been removed. Then the wound is dressed. On the same day, or the following day, you are seen by Dr Parker who performs surgery to reconstruct the area.

Dr Parker will discuss all the surgical options available and recommend the approach that best suits to your situation.

Reconstructive surgery

After a skin cancer is removed, you will need to have the area expertly reconstructed to achieve a functional, comfortable and aesthetically-pleasing result.

Dr Parker’s approach to reconstruction depends on the location and amount of tissue removed as well as the quality of surrounding tissues.

A variety of techniques can be used to reconstruct defects in this area. These include:

  • Direct closure: Where a small wound is sutured and allowed to heal
  • Secondary healing (“laissez-faire”): Suitable for small cancers only
  • A graft or flap

Skin grafts and flaps are areas of skin taken from nearby or another part of your body and placed over the wound to re-construct larger defects. The skin obtained needs to match the eyelid skin as closely as possible. The most common sites for obtaining the skin graft are:

  • Upper eyelid
  • Behind or in front of the ear
  • Above the collarbone
  • Inside the upper arm

Often, a combination of techniques are used. Some of these are done in conjunction with other surgeons, including plastic surgeons and head and neck surgeons.

Multidisciplinary team care

In Australia, skin cancer around the eye is very common and many straightforward tumours are successfully managed by a single surgeon. More complex tumours, however, are best managed with the help of a multidisciplinary team. These teams are usually run through public hospitals and can involve surgeons, oncologists, pathologists, radiologists, and allied health practitioners.

Dr Parker will advise you if this is required in your case and make the necessary arrangements.

If you have skin cancer around your eye, ask your treating doctor for a referral to Dr Parker who can plan your treatment.

If you have skin cancer around your eye, ask your treating doctor for a referral to Dr Parker who can plan your treatment.