Pyogenic Granuloma of the Eyelid:
A case study of Pyogenic Granuloma of the Eyelid
A 44-year-old woman presented with a rapidly growing lesion on her lower eyelid, which developed shortly after she experienced difficulty removing a contact lens. Despite the appearance of the lesion, she reported no pain, tenderness, or discharge. Her vision remained 20/20 with correction in both eyes, and her intraocular pressure (IOP) was within normal limits.
The lesion was identified as a pyogenic granuloma, a common and benign growth of blood vessels. While harmless and not malignant, these lesions have a tendency to recur.
A Historical Note
According to the American Academy of Ophthalmology’s EyeWiki, this condition was first described in 1897 by Poncet and Dor as botryomycosis hominis. Over time, it has been referred to by several names, including:
Lobular capillary hemangioma Granuloma pyogenicum Granuloma telangiectaticum
Treatment Options
Pyogenic granulomas can be managed both surgically and non-surgically:
Surgical approaches include:
Excision Curettage and cauterization Shave excision with laser Blunt removal with chemical cauterization
Non-surgical management may involve:
Cryotherapy with liquid nitrogen Laser ablation Sclerotherapy Topical imiquimod Diathermy Radiation Steroids Bleomycin injection
Patient Management
In this case, the patient opted for conservative treatment. She temporarily discontinued contact lens use and began topical medical therapy.
Follow-up after three weeks showed significant improvement.
Association with Chalazia
Pyogenic granulomas are often linked with chalazia, and in this patient, a chalazion was strongly suspected as a contributing factor. In certain cases, surgical excision of chalazia is necessary to achieve full resolution.
Case Report Acknowledgment
This case was featured in the July 2023 issue of EyeNet Magazine. Credit to Nkechi Nicole Nwabueze, MD, Louise Mawn, MD, and Christine Shieh, MD, with clinical photography by Rocky Munn and Tony Adkins of the Vanderbilt Eye Institute, Nashville, Tennessee.