What are Orbital Tumors?
The orbit is the bony socket in the face that contains the eye, along with muscles, nerves, fat, and connective tissue. The socket is widest at the front and narrows toward the back, where the optic nerve leaves the socket and enters the brain. An orbital tumor refers to any tumor located in the orbit. The orbit is a crowded space, so any tumor in it can cause serious symptoms and functional problems with the eye.
Orbital tumors can be primary, meaning they originate in the orbit. They can also be secondary, meaning that they invade the orbit from the adjacent paranasal sinuses or face. Or they can metastasize from cancer occurring elsewhere in the body, particularly the breast.
What are Some Symptoms of Orbital Tumors?
When a tumor is small, there may not be any initial symptoms. An eye doctor may be able to spot signs of the tumor, however. Otherwise, these are the symptoms of an orbital tumor:
- Eyeball bulging forward or a bump near the eye
- Numbness or tingling around the eye
- Double vision from inability to move one eye in synch with the other
- Vision changes or loss
- Pain around the eye
- Swollen or droopy eyelid
Diagnosing Orbital Tumors
An eye doctor may first spot signs of an orbital tumor when performing a comprehensive eye exam. This allows the doctor to view the back of the eye where details may point to the presence of a tumor, and also to examine and measure many aspects of the eyelids, pupils, eye movements, and the health of all of the surrounding supportive tissues of the orbit.
Once a tumor is suspected, confirmation is achieved with either an MRI or a CT scan. These images will determine the location and size of the tumor. They will also usually show many details about the tumor that will narrow down the possible types of tissue that could be growing. However, a biopsy may be often necessary to establish a definitive diagnosis.
Treatment Options for Orbital Tumors
Treatment options vary with each case, but these are possible strategies:
- Observation — When there are few or no symptoms, and the CT/MRI show characteristics of benign, slow-growing tumors, observation with no treatment is often the best strategy. Later, if things change, one of the options below might be appropriate.
- Surgical options — Surgery to remove an orbital tumor is sometimes straightforward and can be accomplished with hidden incisions inside the eyelids or using natural creases near the eye. This type of surgery is simple, outpatient day surgery. Instead, other tumors may be more complex and often require a multidisciplinary team approach. Dr. Fante works with oncologists; ear, nose, and throat surgeons; neurosurgeons; and craniofacial surgeons when necessary to achieve the best outcomes. Depending on the location and nature of the tumor, the surgeons may be able to approach the eye from the side or from above or below the eye. Reconstruction of the skull and orbit may be required as part of the treatment.
- X-ray therapy — Also known as external beam radiotherapy, this technique can shrink or eradicate certain types of tumors. The eyeball is protected using a special contact lens and side effects are usually minimal.
- Stereotactic radiosurgery — In this method, highly focused beams of radiation are directed onto the tumor to destroy it. It is used for malignant tumors that are not amenable to removal by surgery.
- Chemotherapy — Cancer-fighting drugs are delivered into the bloodstream or sometimes directly into the orbit where they seek out and destroy the cancer cells. Advances in chemotherapy have made it possible to be much more selective in the drug delivery, lessening whole-body toxicity.
What is Recovery from Orbital Surgery like?
Every surgery is unique, so recovery is variable. Following simpler types of orbital surgery, patients will be able to go home the same day and instructions will include use of ice, antibiotics, and eyedrops. Bruising, swelling and temporary numbness of the area are common, but severe pain is not. Other patients who have complex surgery may stay in the hospital from one to three days. Total recovery will last up to six months, although most of the healing occurs in the first six weeks.
What is the Prognosis and Risks Involved with Orbital Tumor Treatment?
For benign, non-cancerous tumors, the prognosis after treatment is usually excellent and the vast majority of people will experience complete recovery with normal function and appearance.
Many malignant tumors can be cured using surgery, radiation and/or chemotherapy. Of course, the pathological diagnosis (from biopsy) and cancer staging will determine the recommended treatment and the likelihood of success in many cases. Depending on the size, location, and type of malignant tumor, complete return to normal function and appearance may or may not be possible.
The risks involved with surgery include, but are not limited, to: bleeding, infection, an asymmetric or unbalanced appearance, scarring, difficulty closing the eyes, double vision, tearing or dry eye problems, inability to wear contact lenses, numbness and/or tingling near the eye or on the face, and possible vision loss.
“Dear Dr. Fante, I just wanted to take a moment to express our collective gratitude to you and your wonderful, compassionate staff. As you’re well aware, this was a very difficult and frightening time for all of us. Aside from my mother’s medical issues, my family was dealt the sad news of the passing of my grandmother. I write this to further contextualize how you and your staff provided our family a calming and steady anchor during this difficult time. For that and for the many kindnesses your showed us, we will always be grateful. Thank you so very much.” G.W.
Schedule a Consultation
If you are interested in treatment for an orbital tumor, contact our Denver office today! Call (303) 839-1616 to schedule a consultation with facial plastic surgeon Dr. Robert Fante.