Orbital Tumors and Surgery

The bony space in which the eye is located is called the orbita (eye socket). Orbital tumors occur as a result of the growth of the structures found here in a different way than normal or the spread of a different tumor in the body to the orbital orbit. Since the orbital cavity has a fixed volume, the first sign of abnormal tissue growth occurring here is dislocation of the eye and decrease in eye functions. Decrease in eye functions may cause vision loss, double vision, corneal melting due to eye dislocation, which is more prominent at night and then constantly observed, as the tumor grows. Vision loss caused by the tumor affecting the optic nerve can cause blindness. Orbital tumors can be benign (benign – not spread to other organs of the body) or malignant (malignant – can spread to other organs of the body). The orbit is like a small room with a solid bone wall on all four sides. An excess of tissue that should not be here can immediately compress the eye and optic nerve in this narrow room, causing vision loss. Even if these tumors are benign, they can exhibit bad behavior by damaging the eye due to their location because they occupy a space in this narrow area. In addition, malignant tumors can be fatal by advancing both to the eye and to the brain in close proximity. Therefore, the treatment of these tumors includes various details. Tumors are treated by using incisions through the eyelids that will leave minimal or no scars around the eyes. Depending on the type and location of the tumor, all or part of it is removed, and additional radiation treatments and/or medicated chemotherapy may be required. This treatment process is done together with the radiation oncology and medical oncology team. The first goal in cancer treatment is to protect the patient’s life, and then to get rid of the tumor by minimally affecting eye functions. Therefore, early diagnosis is life-saving and necessary for the preservation of vision.

Dr. The 3 most frequently asked questions to Onur Konuk about orbital tumors and surgery:

1. I had a dislocation in my eye, my doctor took a film (orbitatomography/MR) and it turned out that there was a mass behind my eye. What should I do?

First of all, it is necessary to understand whether this mass is a benign or malignant type of cancer. In this distinction, a decision is often made with clinical experience and the findings in the film. However, the definitive diagnosis is made by taking a sample (biopsy) from this tumor. This is done in the operating room under biopsilocal or general anesthesia. During this biopsy, either all or part of the tumor is removed. This biopsy specimen is examined pathologically. If the tumor is benign and completely removed during the procedure, there is no additional problem. The patient is followed up with routine follow-ups. If it is malignant, radiation therapy and/or chemotherapy, or additional surgical procedures may be required depending on the type of tumor.

2. What are the risks of orbital tumor surgery?

Orbital surgery is one of the most difficult operations of eye diseases. Performing surgery in a narrow area behind a seeing eye is an undertaking that requires great care and patience associated with the degree of difficulty. These surgeries are often performed under general anesthesia. Therefore, patients do not have serious pain during the surgery, but pain and swelling can be observed in the first 2-3 days after the surgery. Orbital surgery has a theoretical risk of bleeding, infection, double vision and vision loss. However, these risks must be taken into account in the presence of tumors. These risks have been minimized by the practice of experienced oculoplastic surgeons. Post-operative care and good management of current findings are as important as surgery. The medications and care used after the surgery reduce the risks in this process.

3. Will there be recurrence after orbital tumor surgery?

Whether the tumor is benign or malignant, removal of the tumor completely or partially, treatment of additional work after surgery or chemotherapy are the determining factors in the possibility of recurrence. Ideally, it is desirable to completely remove the tumor in one piece. However, in some cases, this may not be possible to protect the eye and optic nerve. The extent of the surgical margin will be explained to you by your doctor during the pre-operative examination and you will be informed about the possible results. At this stage, the earlier the application is made, the more satisfactory the result. Early diagnosis and treatment saves life and vision in most cases.