History of ophthalmologic conditions, including dry eye and excessive tearing.

Personal or family history of skin malignancy or significant sun exposure.

History of previous periorbital surgery or trauma.

Divide the periocular region into “zones” (Fig. 8.2).

Determine layers that have been lost.

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  Full or partial thickness.

  
  
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  Skin, muscle, tarsus, conjunctiva.

Evaluate canthal support and suspected involvement of lacrimal system.

Identify viable elements available for reconstruction (i.e., skin, muscle, tarsus, conjunctiva).

Evaluate eyelid function.

Establish the diagnosis: If it was not done earlier, an incisional biopsy should be performed at initial visit to confirm the pathology.

Confirm negative pathologic margins following initial resection before attempting significant reconstruction.

Magnetic resonance imaging: Useful adjunct in determining extent of tumor and lymph node status in cases of aggressive tumor histology (e.g., perineural invasion or deeply invasive tumors).