Nevi arise from nevus cells, incompletely differentiated melanocytes in the epidermis and dermis and in the junction zone between these 2 layers, and are the third most common benign lesions encountered in the periocular region (after papillomas and epidermal inclusion cysts). The management of simple eyelid nevi in children is similar to that in adults (see BCSC Section 7, Oculofacial Plastic and Orbital Surgery.).
Congenital nevocellular nevi
Congenital nevocellular (also called melanocytic) nevi can occur on the eyelids (Fig 17-12) and may cause visual deprivation amblyopia. They may undergo malignant transformation, the risk of which increases with the size of the lesion; large lesions (>20 cm) have a 5%–20% risk of malignant transformation. Observation is often recommended for small (<1.5 cm) and medium-sized (1.5–20.0 cm) lesions.
Figure 17-11 Pilomatricoma, right lower eyelid. Note the whitish center.
(Reproduced with permission from Lueder GT. Pediatric Practice Ophthalmology. New York: McGraw-Hill Professional; 2010:84.)
Figure 17-12 Congenital nevocellular nevus of the eyelid.
(Courtesy of Amy Hutchinson, MD.)
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.