Tumors and inflammations can occur behind the eye. They often push the eye forward causing a bulging of the eye called proptosis. The most common causes of proptosis are thyroid eye disease and lymphoid tumors (lymphoma and atypical lymphoid hyperplasia).
Other tumors include vascular tumors (e.g. hemangiomas, lymphangioma, hemangiopericytoma), lacrimal gland tumors (e.g. dacryoadenitis, benign mixed tumor, sarcoidosis and adenoid cystic carcinoma), and growths that extend from the sinuses into the orbit (e.g. squamous carcinoma, mucocele). Metastatic cancer can also come from other parts of the body to form an orbital tumor. Lastly, an orbit tumor can also be caused by inflammation (e.g. pseudotumor, sarcoidosis) or infection (abscess).
Symptoms
Most patients with orbital tumors notice a bulging of the eyeball or double vision (diplopia). Infections, inflammations and certain orbital cancers can also cause pain. Less commonly, orbital tumors may be an incidental finding on CT or MRI of the head, sinuses and orbit.
Diagnosis
Though CT, MRI’s and ultrasound can help in determining the probable diagnosis, most orbital tumors are diagnosed by a surgical biopsy called an orbitotomy (anterior or lateral). A specimen is sent to an ophthalmic pathologist who helps determine the exact diagnosis.
Treatments
When possible, orbital tumors are totally removed. If they cannot be removed or if removal will cause too much damage to other important structures around the eye, a piece of tumor may be removed and sent for evaluation by an eye-pathologist. Occasionally an orbital tumor is too big or involves the sinuses and requires more extensive surgery with bone-flaps.
If tumors cannot be removed during surgery, most orbital tumors can be treated with external beam radiation therapy. Certain rare orbital tumors require removal of the eye and orbital contents. In certain cases orbital radiotherapy may be used to treat any residual tumor (in an effort to spare vision and the eye).
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