Orbital lymphangiomas are benign tumors of the eye and are the second most common orbital tumors after orbital hemangiomas. Orbital lymphangiomas are vascular tumors. Orbital lymphangiomas generally attack the soft tissues on the orbital area. So, orbital lymphangiomas can affect the eyelids and the conjunctiva also in addition to the remaining orbital structures. Orbital lymphangiomas occur rarely and their growth in the body is very slow. The orbital lymphangiomas are believed to be congenital and are one of the most common forms of pediatric cancer. Orbital lymphangiomas may not present any signs or symptoms for years. In some cases, orbital lymphangiomas may present in the patient as a mild case of bulging eye. The bulging of the eye takes place when the orbital lymphangioma begins to form a cyst behind the eye which pushes the eye forward. Generally, if a child has orbital lymphangioma it can become visible in the first decade of the child’s life. Although there is no medical proof for the same but more female patients have been known to get affected by orbital lymphangiomas as compared to male patients. Orbital lymphangiomas which are in conjunctiva can become physically visible. Such orbital lymphangiomas do not hamper the vision of the patient.
These tumors are encapsulated and generally are intertwined with surrounding healthy tissues. They also create cysts which are filled with blood and even without an obvious source of blood in them, they can bleed. The nature of these tumors is unpredictable. When they are present in the periocular area they can cause optic neuropathy, proptosis and disfigurement of the face. Tumors can be visible superficially and cause skin discoloration, while some could be deeply situated. The change in the cyst can be very rapid and can immense pressure and pain in the eyes.
Signs and symptoms of orbital lymphangiomas:-
Initially, in the first few years the orbital lymphangiomas generally do not show any symptoms. As the orbital lymphangiomas grow it starts affecting the eye and the vision of the patient. So, because of orbital lymphangiomas the patient may begin to experience bulging of the eye, blurred vision, pain the eyes along with double vision. More than half of the orbital lymphangiomas affect the white portion of the eyes known as the conjunctiva. Orbital lymphangiomas tend to bleed into themselves which leads to formation of cysts in the eyes. The formation of the cysts due to orbital lymphangiomas is dangerous and it can cause complete vision loss in patients. If the orbital lymphangiomas begins to expand it may lead to malfunction of the optical nerves. In few cases like this where the chances of the vision being compromised are high, the patient may need to undergo immediate surgery for excision of the orbital lymphangiomas.
Diagnosis of orbital lymphangiomas:-
One of the most common physical symptoms of orbital lymphangiomas is proptosis. Generally, in case of orbital lymphangiomas the bulging of eye happens suddenly without any apparent cause. Also, if the bulging eye follows a respiratory infection it could be a direct indication of orbital lymphangioma. A combination of ultrasonography and fluoroscopy can be used during the surgery for real time assessment.
What approach for treatment is taken for orbital lymphangiomas in India?
Orbital lymphangiomas are not immediately treated with surgery. Before the surgeon decides to perform surgery for the orbital lymphangiomas the patient is monitored to observe the growth of the orbital lymphangiomas. Orbital lymphangiomas grow very slowly so various parameters are observed before the surgery is performed for completing the treatment. Surgery and an active treatment plan are employed if the orbital lymphangioma suddenly begins to grow really fast or the patient starts to lose vision. If the cyst expansion causes severe bulging of the eyes or causes bleeding it calls for immediate attention. In case, most of the lymphangiomas comprises of cysts filled with fluid treatment becomes necessary. Any lymphangioma which is considered to be a threat to the vision of the patient can be precutaneously drained and ablated which can reduce the potential threat to vision and enlargement of the tumor.
Various approaches are taken to deal with various stages of orbital lymphangiomas. In case of bleeding, if the ocular function is being compromised then the cyst is evacuated and it is collapsed with the help of a sclerosing agent. If the lesion is microcystic, the intralesional sclerosing foam is placed using ultrasonic guidance.
Orbital lymphangiomas are one of the most difficult orbital tumors to be treated because orbital lymphangiomas do not have definitive boundaries. The surgery may have to be followed by radiation treatment to relive the patient of acute pain in the eyes.
In India not many people may have heard of orbital lymphangiomas, but the truth is they do affect very young children and teenagers. In India, many cases of orbital lymphangiomas are diagnosed annually and sadly many cities in India do not even have cancer treatment and surgery facilities. To save a child’s vision and life, it is important that all places in India get best cancer surgery and treatment units by which all children can be treated. Excision surgery and treatment of orbital lymphangiomas need the best doctor who can deal with a child patiently. Sadly, most of the top hospitals in India rush the treatment and surgery of the patients and the situation becomes worse if the patient is a young child or teenager.
In India, Mumbai is one of the best places for the treatment and surgery of orbital lymphangiomas. Generally the excision surgery for orbital lymphangiomas has to be followed by reconstructive surgery. In many cases of orbital lymphangioma in India, surgery is also considered for complete treatment to get the best cosmetic results in addition to removal of the tumor. Orbital tumors can be best handled by an oculoplastic surgeon who can not only deal with the issues of the orbital area but also pay attention to the reconstructive aspect of the treatment. In Mumbai, Dr. Shome is the best oculoplastic and facial plastic surgeon and is immensely experienced in treatment and surgery of the orbital lymphangiomas. Dr. Shome has been through one of the top oculoplastic fellowships and depth of knowledge in such a fellowship is incomparable. He has been practicing in Mumbai for almost 15 years now and has multiple fellowships in various branches of cosmetic and plastic surgery. The surgery of orbital lymphangiomas can be very complicated and when Dr. Shome performs surgery for orbital lymphangiomas in Mumbai, he aims primarily at saving the vision of the patient. His track record of treatment and surgery on young children in Mumbai is 100% successful which means not only the vision of the patients was preserved but best cosmetic outcome was also achieved. He is famous amongst his patients for not only being one of the best surgeons in Mumbai but also for his calm demeanor and poised approach towards his patients. His reputation has made him one of top surgeons to be called in for surgery and treatment of orbital lymphangiomas in Mumbai by various reputed institutions. In his role as a consultant to the best hospitals in Mumbai, he has excelled and treated foreign patients also. With a single-minded focus on the well being and holistic treatment of his patients, he is providing the best treatment and surgery for various ophthalmic, oculoplastic, maxillofacial and facial plastic issues in Mumbai. India’s journey towards medical supremacy has been paved by hard work of the some of the top surgeons of India like Dr. Debraj Shome. If you want the top class treatment and surgery for your ailments by one of the top surgeons in India, book an appointment with Dr. Shome.