Any tumor which either grows inside the orbital area or crosses over the orbital cavity into the nearby structures of the orbital area like the optic nerves and muscles is known as orbital tumor. Tumors have a tendency to metastasize and if a tumor does not grow inside the orbital area but invades from some other body part, then also it is known as orbital tumor. Orbital tumors often cause a condition which is known as proptosis in which the eye bulges out of the orbital cavity because of pressure of tumor behind the eye. Orbital tumors are often categorized by their origin. So there can be three categories of orbital tumors as follows:-
- Orbital tumors which originate in the sinus and invade orbital cavity like squamous carcinoma tumor.
- Orbital tumors which originate in the orbital cavity like the tumors of the lacrimal gland, hemangiomas etc.
- Orbital tumors which originate elsewhere in the body and invade the orbital cavity.
Orbital tumors may also have entirely different cause like the inflammation or abscess.
Types of common orbital tumors:-
- Retinoblastoma: – This type of orbital cancer is very common in children. This type of tumor originates in the retina of the eye. In almost all cases, Retinoblastoma occurs due to changes in RB1 gene. Two types of Retinoblastoma can occur in children depending upon the gene mutation pattern; congenital Retinoblastoma and sporadic Retinoblastoma.
- Cavernous Hemangioma: – Cavernous Hemangiomas are benign and generally do not cause any pain. They gradually cause the eye to bulge. In most cases, cavernous hemangiomas are found in one eye only and rarely are they found in both the eyes. As a cavernous hemangioma grows it can cause acute vision problems, pupillary dysfunction, double vision, optical nerve damage etc. Cavernous Hemangiomas are mostly found in women.
- Orbital Varix: – Orbital varices are lesions which are characterized by sporadic and random bulging of the eyes. They are categorized as primary or secondary depending upon how they are acquired. Primary Orbital varices are congenital and generally remain confined to the orbit. Secondary Orbital varices are formed due to presence of venous malformations somewhere else in the body.
- Orbital lymphangiomas: – Orbital lymphangiomas are also known as orbital lymphatic malformations. Orbital lymphangiomas are benign tumors which occur in the orbital lymphatic channels. Orbital lymphangiomas can cause the eyes to bulge slowly but in some cases the eye may pop-out suddenly because of hemorrhage. Because of the bleeding or the tumor itself, the optic nerves may get compressed causing vision loss.
- Orbital Inflammatory disease: – It is also known as pseudotumor or inflammatory orbital pseudotumor and can occur anywhere within the orbit. The orbital inflammation disorder can be idiopathic in nature or may be an indication of an underlying condition. There could be various symptoms of this condition like double vision, complete vision loss or proptosis. Most likely symptom of Orbital Inflammatory Disease is sudden onset of swelling and pain in the eyes.
- Orbital lymphoma: – It is one of the most common types of orbital tumors and is a non-Hodgkin lymphoma. There are two categories in which orbital lymphomas are mainly divided; adnexal lymphomas and intraocular lymphomas. Orbital lymphomas become progressively worse, however if a patient complains of sudden acute pain in orbital area it could indicate some other issue. Orbital lymphomas can lead to formation of orbital mass and bulging of the eyes.
Orbital tumors are completely curable and can be removed by surgery. The surgery to remove orbital tumors is known as orbitotomy. The surgery for orbital tumors is a very delicate surgery because all the nerves, blood vessels etc. in the orbital area are very minute and very difficult to handle.
Prognosis of orbital tumors:-
Generally, the prognosis post the surgery of orbital tumors is quite good and the orbital tumors generally do not relapse as well. However, if for any reason the detection or the treatment is delayed, it may cause a lot of complications before and after the surgery.
Symptoms of orbital tumors:-
- Double vision
- Bulging of the eyes
- Pain in the orbital area
- Inflammation and severe infection in the orbital area
Diagnosis of orbital tumors:-
Generally, once the symptoms of the orbital tumors are observed, the confirmation is done through MRI and CT scans. A biopsy of the orbital area may be done before the surgery to confirm the diagnosis.
Treatment of orbital tumors:-
The best treatment for the orbital tumors is surgery. With surgery the orbital tumors can be removed fully. But in some cases the orbital tumor may be located in a way that surgery could cause massive collateral damage to the surrounding structures.
In cases where the orbital tumors are very large, bone flaps may be required during the surgery. All efforts are directed towards saving the eye and the vision of the patient by surgery. If orbital tumor is not treatable by surgery, then radiation is used to shrink the orbital tumor. In very severe cases, orbital tumor may lead to enucleation by surgery. An enucleation surgery would mandate the treatment by an oculoplastic surgeon because a prosthetic eye would be required after this surgery. New age prosthetic eyes look absolutely natural and an oculoplastic surgeon would ensure that not only the orbital tumor is removed by surgery but the aesthetic outcome is also very pleasing in such surgery.
Orbital tumor surgery in India:-
Orbital tumors in most cases are benign which means they do not spread. But a surgery is mandatory in almost all cases. In India, cases or orbital tumors are quite common and many ophthalmic clinics in Mumbai routinely carry out surgery for orbital tumors. But most orbital tumors surgery also requires reconstruction which should be done by an oculoplastic surgeon. The most famous oculoplastic surgeon in Mumbai is Dr. Debraj Shome who is the top surgical specialist in Mumbai and all over India. Dr. Shome is one of those few top surgeons in India who have saved many patients from enucleation. All his patients from Mumbai and rest of India never get disappointed after the surgery. At his clinics in Mumbai he routinely performs reconstructive surgery after the removal. Only a few surgeons in India can perform plastic surgery of the ocular area and Dr. Shome who is based in Mumbai is one those best surgeons. Dr. Shome has been honored many times in Mumbai as well as the rest of India for his outstanding work in the field of oculoplastic surgery. He is at the top in his field and his patients who come to him in Mumbai from the rest of India could not agree more. He is indeed the best and the number of patients that come to visit him in Mumbai from the rest of India is a testimony to this fact. India only has a few oculoplastic surgeons but no one has credentials that match with Dr. Shome. Dr. Shome is attached to various top hospitals in Mumbai who want to benefit from the best of his knowledge on various special surgery cases from all over India. Mumbai is now one of the best places to get surgery for orbital tumors because of the best medical facilities in India. Dr. Shome is on a mission to share his wisdom and provide top treatment to people all across India and not just Mumbai. India is one of the top countries in the world where the number of people suffering from orbital tumors is increasing every year. Various cancer research hospitals are coming up in India and especially in Mumbai. Dr. Shome hopes to provide orbital surgery to as many patients as possible at his clinics in Mumbai. The standard of surgery and after care is the best at the Mumbai clinics of Dr. Shome.