Orbital Tumors

• Orbital tumors can cause prominence of the eyes, pain, double vision or blurred vision
• We are members of a skull base surgical team specializing in orbital tumor removal
• New technology may permit small incision removal of the orbital tumor

Fortunately, orbital tumors are very rare. There are over 1500 different tumors that can affect the orbit. The majority of these tumors are benign. These tumors cause problems because of their location and proximity to vital structures and organs including the eye, the muscles that move the eye, the lacrimal gland, the nerves and vessels of the orbit, the sinuses and the brain. Occasionally, a malignant tumor may involve the orbit primarily or through spread from an adjacent or distant tumor. These lesions not only cause problems because of their proximity to vital structures, but also the risk of spread to adjacent and distant organs.

Most tumors of the orbit cause symptoms including protrusion of the eye, pain, double vision and redness. Many of these tumors require a biopsy to determine the nature of the lesion and appropriate treatment. Surgery in this small space with many vital structures is very difficult and tedious.

Preoperative Evaluation

There are many different types and locations of orbital tumors that can occur. A thorough past medical history is taken with a particular note of any previous tumors.  As with the treatment of any other orbital abnormality, it is imperative that all patients have a thorough examination of their eye.  This starts with a measurement of the visual acuity.  A complete examination of the ocular surface, tear film and contents of the eye is performed.  Frequently, orbital tumors can occur in association with a systemic illness which must be addressed.

The Surgery

Surgery for orbital tumors is individualized to the patients particular tumor and location of the tumor.   Orbital surgery is most commonly performed under general anesthesia as an outpatient or a short inpatient stay.  Frequently, patients are asked to arrive 1-2 hours prior to surgery.  This allows the nursing staff to draw appropriate lab work, start an IV and answer any further questions you may have.  An anesthesiologist will discuss anesthesia prior to surgery and answer any questions you may have.

Postoperative Care

Postoperative care after correction of orbital surgery is individualized to the patient’s specific abnormality.  It is not uncommon to be instructed to leave an eye patch on for 24 hours.  The patient may be instructed clean to clean the wounds with a sterile saline solution or hydrogen peroxide twice daily and antibiotic ointment placed on the wounds.  Many patients are treated with oral antibiotics for 5-7 days after surgery.  A follow-up appointment with your physician will be scheduled within 5-7 days.

Complications

Orbital surgery is very complex.  Bruising and swelling are common and usually subsides within 1-2 weeks.  It is not unusual for patients to experience transient double vision after surgery.  The double vision usually disappears within several weeks.  Significant scarring and pain are unusual as is an infection.  As with any surgery in and around the eye, there is a risk of loss of vision.  Any significant postoperative bleeding, pain, redness or visual disturbances must be reported to your physician.

Complications are rare and include bleeding, infection, bruising, swelling, double vision, scarring and loss of vision.  Because we have a unique understanding of the eye and plastic surgery, we are the only specialty trained to treat orbital tumors.