Eyelid Growths

One of the most technically challenging aspects of oculoplastics is paediatric surgery. The need for precision is paramount because even the slightest error can have lasting consequences on a child’s development.


Eyelid growths or swellings are common in children, and the majority of them are benign. Most are styes or chalazion, caused by a blockage of the oil glands and will resolve without treatment. In more serious cases, the cause of a swelling may be an orbital tumour.

London Ophthalmic and Oculoplastic surgeon Dr Nick Koutroumanos is highly experienced in reconstructive eyelid, orbital, and lacrimal surgery for adults and children. He treats common conditions as well as complex cases affecting the eyelid, lacrimal, and orbit systems.

Dr Nick rises to the challenge of paediatric surgery and operates on many children in his NHS and private practice. He focuses on minimising the stress and anxiety felt by the child and family by creating a calm, reassuring environment.

Paediatric Eyelid Lumps & Bumps

A stye, or hordeolum, is caused by a bacterial infection. The resulting inflammation affects the eyelash follicles or oil glands, and a slight red swelling appears on the eyelid with a yellow or white centre. They can occur singly or multiple or affect both eyelids. It can be externally visible or present inside the lid.

Styes affect children more often than adults and usually resolve with at-home treatment such as repeated application of a warm, wet compress on the eye. Occasionally, a more severe infection can cause significant swelling and even eye closure. This is called cellulitis and requires treatment with oral antibiotics.

A chalazion is an eyelid cyst, typically a slow-growing and painless lump in the eyelid. It is caused by a blockage of the oil gland, often due to a stye or blepharitis. If infected, the entire eyelid may become swollen and painful, and if situated on the upper eyelid, it can distort the shape of the cornea, affecting vision.

Usually, chalazion resolves without medical intervention and is relieved by repeated application of a warm compress. Sometimes, a steroid injection or oral antibiotics may be required. In some cases, chalazion may need to be drained surgically.

Paediatric orbital tumours may be found in the bones, muscle, optic nerve, or soft tissues. They are typically congenital, meaning they have been present from birth. Parents may notice one eye is more protruding or open, or their child is experiencing double vision or loss of vision if the tumour affects the back part of the eyeball. Most orbital tumours in children are benign, such as dermoid cysts or haemangiomas.

Dermoids are the most common swelling of the orbit in children. They are usually present at birth and slowly enlarge with age. They are usually found in the outer part of the upper eyelid and present as a smooth, firm, painless swelling. Orbital dermoids may require removal if they affect vision or cause a lazy eye to develop.

An orbital dermoid is usually diagnosed from a medical eye examination, but deeper dermoids may require imaging. Surgery is often necessary to remove them.

These are red or bluish lumps that usually appear in the first weeks or months after birth. After quickly growing, they typically disappear independently over the following years without medical intervention. They only require treatment if they hinder eye function or for aesthetic reasons.

Cancerous tumours in children include rhabdomyosarcoma, which grows in muscle or connective tissue, and retinoblastoma, which grows inside the eye’s retina. Parents may notice that one pupil is larger than normal, there is redness or swelling near the eye, or one of the eyes is larger or more protruding.

Tumours are diagnosed with a medical eye examination and diagnostic imaging such as ultrasound, CT, and MRI scans. Treatment is usually surgery to remove the tumour, laser therapy to kill tumour cells, radiotherapy, and chemotherapy.

Oculoplastic surgeon London


Dr Nick Koutroumanos

Dr Nick Koutroumanos is a London-based Ophthalmic & Oculoplastic surgeon, with particular subspecialty expertise in ophthalmic plastic & reconstructive eyelid, orbital and lacrimal surgery.

His private practice, based at The Hospital of St John & St Elizabeth in St John’s Wood complements his work in charge of a large NHS oculoplastics practice at the Royal Free Hospital in Hampstead.

A qualified senior trainer and Royal College Examiner in ophthalmic plastic surgery, cataract surgery and general ophthalmology, he runs an Oculoplastics Fellowship training programme that is highly sought-after by both UK and international candidates.

Kind Words from Our Patients


A true perfectionist

Words are not enough to express my sincere gratitude for the care and dedication Dr Koutroumanos put into my journey. I felt safe and secure in his hands. This is someone who truly cares about outcome and ethics of practice. A true perfectionist. I would not hesitate to wholeheartedly recommend him.

100% worth it

I had surgery a few days ago with Dr Koutroumanos for congenital ptosis. It’s early days but I don’t think it’s too early to say the results will be life changing for me in terms of confidence levels. I struggled at school due to the condition and have learnt to live with it – that is until I saw the doctor who was reassuring from the start and has just done the best job. 100% worth it and amazing to know I was in such safe hands. I can’t thank him enough.

I’m really happy with my results

I’ve recently had a brow lift and blepharoplasty with Mr N Koutroumanos. The whole process from start to finish was handled professionally and each process was very informative. I’m still at the recovery stage, so far I’m really happy with my results. Highly recommend using Mr N Koutroumanos services.