DISEASES AND TREATMENTS

Orbital tumours

What are orbital tumours?

They are tumours located in the orbit (the cavity in which the eyeball is housed). They are rare. Most are benign and evolve slowly. However, some malignant tumours can appear suddenly, growing very rapidly. In this case, it is necessary to go to the ophthalmologist urgently, because treatment may be required as soon as possible.

Causes

Most orbital tumours are congenital.

Symptoms

The patient may experience proptosis or exophthalmos (anterior displacement of the eyeball), pain, alterations in eye mobility, eyeball displacement or loss of vision caused by compression of the optic nerve due to the tumour.
Malignant tumours can appear suddenly and grow very rapidly without having shown any previous symptoms.

Orbital tumour surgery

It consists of surgically extracting the tumour generating the least possible scar, but ensuring total extraction of the lesion, and then using reconstruction techniques to enable an optimal aesthetic and functional result, and, depending on the case, the help of chemotherapy or radiotherapy may be necessary, applied in coordination with an oncologist.

Malignant lesions can reappear over time, in the same place or in its proximity, so it is advisable to carry out a regular follow-up after surgery. The procedure is performed under local anaesthesia and in some cases under sedation.

Surgery process

Previous examinations

A complete eye and eyelid examination should be performed. Depending on the type of tumour suspected, diagnostic support tests are required in some cases.

Before the surgery

Do not take blood thinners or aspirin before surgery.

Risks

They often affect the patient’s life; that is, they may be lethal, and the surgeon’s attitude greatly impacts the future of that patient’s life, thus requiring greater dedication and sub-specialisation, if need be.

Another important thing about tumours is that there are always three aspects to consider: aesthetic, functional and vital.

The aesthetic aspect is that the orbit is approached in such a way that no one knows where the entry is made, and the incisions are concealed. The approach routes are becoming more complicated for the surgeon but better for the patient, because no one knows where the entry has taken place.

The functional component; in other words: How do these tumours affect vision? What are the repercussions? When can the eye and vision be saved? When does the vision or eyeball have to be sacrificed?

And then there is the oncological or vitalcomponent we actually always have to keep in mind. Depending on how these tumours are approached, let us not forget that the orbit is a few millimetres from the central nervous system. There are direct connections with the central nervous system, and these tumours, when they are not benign, can very easily spread to the brain, metastasise to lymph nodes or distant metastasis and end the patient’s life. Therefore, it is very important that this type of tumour is guided by a person with a great deal of experience and very good training in orbital oncology.