Orbital Tumor Surgery
Understanding Orbital Tumors
An orbital tumor is an abnormal growth that develops in the orbit, which is the bony socket that holds your eye, muscles, nerves, and blood vessels. These tumors can grow within the muscles that move the eye, the optic nerve, the tear gland, or the fat surrounding the eye. While the word 'tumor' often sounds alarming, many orbital growths are benign, meaning they are not cancerous and do not spread to other parts of the body.
Our ophthalmologists have experience treating a wide range of orbital conditions. Identifying the specific type of tumor is the first step toward creating an effective treatment plan. We categorize these growths based on where they start and whether they are benign or malignant (cancerous).
- Vascular lesions: These are growths involving blood vessels, such as cavernous venous malformations, which are common and benign in adults.
- Lacrimal gland tumors: These grow in the tear gland. Some, like pleomorphic adenomas, are benign, while others may be malignant.
- Neural tumors: Growths like optic nerve gliomas, meningiomas, or schwannomas that affect the nerves behind the eye.
- Cysts: Benign, fluid-filled sacs, such as dermoid cysts, that are often present from birth but grow slowly over time.
- Lymphomas: Tumors affecting the immune system cells in the orbit, which often require coordination with oncologists.
- Metastatic tumors: Cancer that has spread to the eye socket from other parts of the body, such as the breast, lung, or prostate.
For most patients, orbital tumors develop without a clear cause. They are generally not caused by injuries or common sinus infections. However, certain factors can increase your risk. Some genetic conditions can make tumors more likely, and a history of radiation treatment to the head or face may also play a role. Your age and general health help us narrow down the potential diagnosis.
Not every orbital tumor requires immediate removal. If a tumor is small, benign, and not affecting your vision, our ophthalmologists may recommend 'watchful waiting.' This means we monitor the growth closely with regular imaging exams. Surgery becomes necessary if the tumor grows, causes pain, pushes on the optic nerve, or affects the position of your eye. In cases where cancer is suspected, we may perform surgery to remove the tumor or take a biopsy sample for testing.
Recognizing Symptoms and Warning Signs
Because the eye socket is a small, enclosed space, even a small growth can cause noticeable symptoms as it presses on delicate structures. Recognizing these signs early allows for prompt evaluation and treatment.
The most common sign of an orbital tumor is proptosis, or eye bulging. You might notice that one eye looks more prominent than the other or feels like it is being pushed forward. Sometimes, the tumor pushes the eye to the side, causing it to look out of alignment. This usually happens slowly over weeks or months.
As a tumor grows, it can press on the optic nerve or the eye itself. This can lead to a variety of vision problems that should be checked immediately.
- Blurry vision or blind spots in one eye.
- Double vision (seeing two images), especially when looking in a specific direction.
- Colors looking washed out or less bright.
- Loss of peripheral (side) vision.
Some patients feel a dull ache or a sense of pressure behind the eye. However, many tumors are painless, especially in the early stages. If you experience sudden, sharp pain, it could indicate rapid growth or inflammation.
While most tumors grow slowly, some situations require urgent medical attention to save your vision. If you experience sudden vision loss, severe pain that medicine does not help, or rapidly worsening eye bulging over just a few days, please seek emergency care immediately. Signs of infection, such as fever and redness with swelling, also require urgent evaluation.
Diagnosis and Surgical Planning
At ReFocus Eye Health Marlton, we use advanced technology to get a clear picture of your condition before discussing surgery. Accurate diagnosis helps us plan the safest and most effective approach for your specific anatomy.
To see inside the bony eye socket, we rely on CT scans and MRI scans. A CT scan gives us excellent views of the bone structure, while an MRI provides detailed images of the soft tissues, optic nerve, and the tumor itself. These images show us the exact location and size of the growth, helping us decide if surgery is the best option.
In many cases, we need to take a small tissue sample, called a biopsy, to confirm exactly what type of tumor you have. This is examined under a microscope by a pathologist. For certain suspected tumors, like lymphoma, a biopsy is crucial for guiding treatment. For others, such as lacrimal gland tumors, we may aim to remove the entire growth at once rather than just taking a sample, to prevent the tumor from spreading cells in the orbit.
Before your procedure, we will ensure you are healthy enough for surgery and anesthesia. This usually involves a visit to your primary care doctor for medical clearance. If you take blood thinners, we will coordinate with your doctors to safely pause them. We encourage you to stop smoking before surgery, as this helps your body heal faster.
What to Expect During Surgery
Our goal during surgery is to remove the tumor safely while preserving your vision and the appearance of your eye. We use precise techniques tailored to the location of the tumor.
The way we access the tumor depends on where it is sitting in the eye socket. For tumors on the side of the eye, we may use a lateral orbitotomy, which involves a small incision near the temple. For tumors deeper in the socket or near the nose, we may use techniques that hide incisions inside the eyelid or work in collaboration with other specialists to go through the nose (endonasal approach). We always aim to use the least invasive method possible.
Most orbital surgeries are performed under general anesthesia, so you will be completely asleep and comfortable throughout the procedure. The surgery typically lasts between two and four hours, though complex cases may take longer. Our team monitors you closely the entire time.
All surgeries carry some risk. Because we are operating near the eye and brain, potential complications can include bleeding, infection, double vision, or drooping eyelids. In rare cases, vision loss can occur. We will discuss your specific risks in detail during your consultation so you can make an informed decision.
Recovery and Aftercare
Recovery is a gradual process. Our team will provide you with detailed instructions on how to care for your eye at home to ensure the best possible result.
After surgery, you will likely have a bandage or eye patch. Swelling and bruising are normal and typically peak two to three days after the procedure. You should rest with your head elevated on pillows to help reduce swelling. Most patients go home the same day, but some may need to stay overnight for observation.
You may feel some discomfort or a dull ache, which can usually be managed with prescribed medication. It is important to avoid heavy lifting, bending over, or straining for at least two weeks, as these activities can increase pressure in the head and cause bleeding. Most patients can return to light desk work in one to two weeks.
- Apply cold compresses gently (not directly on skin) to reduce swelling.
- Avoid blowing your nose if instructed, especially if the sinuses were involved.
- Do not drive until your vision is clear and you are off strong pain medication.
We will see you for a follow-up visit about a week after surgery to check your healing and remove any stitches. Long-term monitoring is important, especially for tumors that have a chance of returning. We will set up a schedule for regular eye exams and imaging scans to ensure your eyes remain healthy.
Frequently Asked Questions
Our primary goal is to protect your vision. While there is always a risk when operating near the eye and optic nerve, permanent vision loss is rare for most standard orbital procedures. We use careful surgical techniques to minimize this risk.
Not necessarily. Many orbital tumors are benign, meaning they are not cancer and do not spread. However, even benign tumors can cause problems if they grow large enough to press on the eye. We use biopsies and imaging to determine if a tumor is malignant and requires cancer treatment.
Benign tumors that are completely removed usually do not come back. If a tumor is malignant or if we could only safely remove part of it, there is a higher chance of recurrence. We will monitor you closely with regular scans to catch any changes early.
This depends on the type of tumor. Benign tumors typically do not need further treatment after removal. If the tumor is lymphoma or another type of cancer, we will work with oncologists to arrange for radiation or chemotherapy if necessary.
Expert Care Close to Home
Dealing with an orbital tumor requires a team you can trust. At ReFocus Eye Health Marlton, we combine advanced medical technology with a personalized, caring approach. Whether you live right here in Marlton, NJ, or travel to us from the Greater Philadelphia area, our ophthalmologists are committed to providing you with the highest standard of care to protect your sight and your well-being.
I saw Dr. Glass for my post cataract surgery appointment and he and is team are always pleasant and thorough.
Sandra Pruss
I came in for an emergency appointment, and they accommodated me and handled my care with compassion and professionalism. Doctors are always prepared, and aware of my medical conditions and concerns.
Cathy Quattrone
Staff was courteous, thoughtful and helpful. Dr Johnson was warm and listened. He immediately found the problem and began addressing it. I’m comfortable I’m on the right track.
CS
I had an absolutely AMAZING visit! Staff was so very, very kind, helpful and professional! I had Dr. Paul Johnson! I highly recommend him! He is patient and considerate,and very professional!
Tracey Baytops
Dr. Charles Glass is the bestest! He is magnificent at his profession and very personable. The staff all around, are very nice and knowledgeable.
Joyce Martin
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