The orbit, another term for the eye socket, is the bony space behind the eye that houses the eye, the eye muscles, the eyelids, nerves, blood vessels, and fat. There are a wide variety of growths that can affect the eye socket. Most of these tumors are benign, but some can be malignant and life- and sight-threatening. At Oasis Eye Face and Skin, board-certified oculofacial plastic surgeon Dr. Vivian Schiedler can accurately diagnose and provide comprehensive care for orbital tumors and other eye disorders.
Orbital tumors can be caused by exposure to radiation, metastasis, genetics, or an unfortunate DNA mutation. Orbital tumors can originate directly in the eye socket, and these are known as primary tumors. If the cancer originates in a different location before spreading to the orbit, then it is called a secondary tumor or metastasis. Orbital tumors can occur in both children and adults.
Eye socket tumors and inflammation can develop in the socket, often causing the eye to be pushed forward. Although many eye socket tumors are benign, it is essential to seek medical attention since any kind of tumor can cause problems due to the tight space behind the eye. Common types of orbital tumors include:
This is a tumor that arises from the structure surrounding the brain known as the meninges. This protective sheath surrounds the brain, optic nerve, and spinal cord. It can grow into the eye socket causing the eye to bulge forward.
This is a malignant growth of lymphocytes, a type of white blood cell. It has a tendency to grow in the lacrimal gland of the eye. Fortunately, it is not very common. After biopsy confirms the diagnosis, low-dose radiation is known to have a great cure rate.
A sinus related tumor, mucoceles or fluid-filled cysts can develop in people who suffer from chronic sinusitis. The cysts erode into the eye socket in people with chronic sinusitis and can lead to eye displacement.
This the most common type of orbital tumor. It appears as a smooth round or oval reddish tumor. Sometimes people who develop a small cavernous hemangioma fail to display any symptoms, and the problem is found incidentally when they have a CT scan. Cavernous hemangiomas are very slow growing, which is why symptoms don’t develop until adulthood.
There are several types of blood vessel tumors. A common one in children is capillary hemangioma, which looks bluish if located near the surface. Another cause is a distended vein, called a varix, which is similar to varicose veins found in the leg. A varix can cause an ache around the eye, especially when bending over or lifting something heavy.
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Because many orbital tumors are slow growing, patients may not display symptoms until the tumor has become large. A change in your eye prescription, called a hyperopic shift, may be the first sign of the growth. Dr. Schiedler, being an ophthalmologist and oculofacial plastic surgeon, is skilled at looking for specific signs of underlying causes that could cause an orbital tumor.
Symptoms to pay attention to include:
As with any type of tumor or cancer, imaging studies including CT scans, MRI scans, and ultrasound are used to diagnose an orbital tumor. CT scans are good for evaluating the bone structures, while MRIs are good for looking at soft tissues. Confirmation of the diagnosis is often made with a biopsy. Excision, or removal, of the lesion may be necessary, with the added bonus of being confirmatory and the treatment. If it is a lesion that is not visually threatening nor concerning for malignancy, periodic CT and/or MRI scans may be performed to observe for any changes.
The two main categories for treatment are surgical and medical. The type of treatment is entirely dependent on the type of tumor present.
When a tumor is causing vision problems or pain, it may be necessary to remove it via surgery. This is typically done under general anesthesia, and most patients can go home the same day. If the tumor is located behind the eye, the surgery may cause some temporary double vision. Surgery in the eye socket is relatively risky and should only be performed by an oculofacial plastic surgeon. Complex orbital tumor cases may involve the brain and other critical structures behind the eye socket. As such, these types of tumors will often require multidisciplinary care between neurosurgery, oculofacial plastic surgery, and ENT head and neck surgery.
Some orbital tumors, such as lymphoma, are best treated with less invasive methods like radiation. Depending on location or if other treatments have been unsuccessful, gamma knife radiation may be helpful. This method can be used when surgery would be too risky or when the tumor is tucked at the back of the eye socket. Instead of using a scalpel, gamma knife radiation uses targeted narrow beam gamma rays to destroy the lesion.
Most benign eye socket tumors have an excellent prognosis and are successfully removed with surgery. Following treatment of the tumor and depending on the treatment selected, eye reconstruction may be needed. Dr. Schiedler is highly specialized in reconstructive and cosmetic surgery of the eyes and will work with you to achieve the best possible results.
Orbital tumors should be treated by a specialist. Working with an oculofacial plastic surgeon with a background in ophthalmology and orbital diseases, such as Dr. Vivian Schiedler, improves your odds of successful tumor treatment with minimal side effects. It is her priority to provide the best care possible. She and her expert staff at Oasis Eye Face and Skin will take the time to fully educate you about your condition, surgical plan, and recovery. Contact Dr. Schiedler at (541) 708-6393 and schedule your consultation today!