Meibomian Cysts - referral guidance

The guidance details the circumstances in which a referral can be made under the NEW Devon CCG Benign Skin Lesion Policy.

Management

The removal of a benign skin lesion, wherever it appears on the body is regarded as procedure of low clinical priority. Surgery to improve appearance alone is not provided.

Meibomian Cysts (Chalazia) are benign, granulomatous lesions of the upper or lower eyelid that will normally resolve within 6 months with conservative management.

Conservative treatment consists of regular (four times a day) application of heat packs and massage.

Referral

Referral Criteria

Incision and curettage of Meibomian Cysts will be funded where the following criteria are met:

  • The Meibomian Cyst has been present continuously for more than 6 months
  • Where conservative treatment has failed (see above)

and is either

  • present on the upper eyelid and interfering with vision

or

  • The Meibomian Cyst is regularly infected (e.g. 2 times within six month time frame) and in need of medical treatment for infection

Indications for direct referral

  • Recurring cysts
Meibomian Cysts that keep recurring or have atypical features require biopsy to rule out malignancy.
  • Diagnostic uncertainty
Suspected eyelid malignancy should be referred for specialist opinion. Please refer to the provider directory of service for guidance as to which clinics these patients should be booked into.
Once it is established that a lesion is a simple Meibomian Cyst and that it is not malignant its removal will not normally be funded by the NHS though a clinician may request exceptional funding. Clinicians referring on this basis should make the patient explicitly aware that removal of the lesion may not occur.

Exceptions

Children under the age of 10

Meibomian Cysts may cause astigmatism and visual development could potentially be at risk up until the age of 10. In these circumstances the removal of the cyst may be undertaken as an exception to the decision not to fund the procedure.

NEW Devon CCG guidance for the management of referrals for Meibomian Cysts

Referral Instructions

Patients who are not eligible for treatment under this policy may be considered on an individual basis where their GP or consultant believes there is an exceptional clinical need that warrants a deviation from the rule of this policy.

Individual cases will be reviewed at the PCTs Restricted Treatments Funding Panel upon receipt of a completed application from the patient's GP, Consultant or Clinician.

Applications for consideration for funding approval should be sent to:

Email: d-ccg.ifr-newsdt@nhs.net

Alternatively, please send to: The Panel administrator at Bridge House, Collett Way, Newton Abbot, TQ12 4PH

Supporting Information

 

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