Dr Louise Kuegler and Dr Sid Ogra explore the assessment and management of eyelid lesions in primary care. They discuss a clinical case of a 67y female with a non healing lesion on the eyelid. Unpacking how to distinguish benign from malignant lesions, highlight key red flags such as non-healing or changing lesions, and emphasise the importance of early recognition and timely referral. The conversation covers common conditions including actinic keratosis, basal cell carcinoma and melanoma, along with practical strategies such as thorough history-taking, clinical intuition, and the use of photography for monitoring. Preventive approaches, including sun protection and awareness of risk factors, are also discussed to support better patient outcomes.

Practical clinical pearls:

• Most eyelid lesions are benign (however as they are in a functional place, if large may still need to be removed)
• Malignant lesions are usually treatable if caught early
• Red flags to watch for: Loss of eyelashes (Number one by far). Non-healing areas of skin or styes that after 3/12 have not resolved as expected- this could be sebaceous cell carcinoma. Bleeding and ulceration.
• If uncertain of diagnosis→ refer early

Speaker Bio:

Dr Sid Ogra, MBChB, FRANZCO

Specialist in Oculoplastics (eyelid and tear duct disorders) – adults and children

Specialist in cataract surgery, including premium lenses and refractive correction

Dr Sid Ogra is a well-established ophthalmologist with subspecialty expertise in oculoplastics and a busy cataract surgery practice. He provides care across Auckland and Queenstown, seeing both adult and paediatric patients.

Sid graduated with distinction from the University of Auckland and completed his ophthalmology training across Auckland, Rotorua and Wellington. He then undertook an Oculoplastic Fellowship in Hereford, UK (2019), further refining his surgical skills in eyelid and tear duct disorders.

He has also completed observerships at the Byers Eye Institute at Stanford (USA) and Samsung Medical Centre in Seoul (South Korea), gaining additional international experience in advanced ophthalmic care.

Sid is committed to a collaborative approach, working closely with patients to ensure they are well informed about their condition and treatment options, and supporting shared decision-making to achieve the best possible outcomes.

Resources:

Bernardini, Francesco P. Management of malignant and benign eyelid lesions. Current Opinion in Ophthalmology 17(5):p 480-484, October 2006. | DOI: 10.1097/01.icu.0000243022.20499.90

Sun, M. T., Huang, S., Huilgol, S. C., & Selva, D. (2019). Eyelid lesions in general practice. Australian Journal of General Practice, 48(8), 509–514. https://search.informit.org/doi/10.3316/informit.554448397575586

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