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Diagnosis and treatment of orbital tumors

The orbit contains the bones of the eye socket, the eyeball, the eye socket muscles, the optic
nerve and surrounding fat. Orbital disorders can cause prominence of the eye and consist of
thyroid eye disease, inflammations and infections of the orbit, orbital tumors, injuries and
fractures of the orbit and eye socket problems. These disorders may require reconstructive or
cosmetic surgery.

Orbital tumors are tumors occurring in the bony eye socket behind the eye. Orbital tumors can
affect adults and children, and can be benign or malignant. Most common benign tumors in
childhood are dermoid cysts and capillary hemangiomas. Rhabdomyosarcoma is the most
common malignant tumor affecting children and presents as a rapid onset of pain, eyeball
protrusion and swelling of the eyelids. It requires immediate recognition and treatment.
Lymphomas are the most frequently occurring malignant orbital tumors in adults.

Symptoms of an orbital tumor may include:

  • Protrusion of the eyeball (proptosis)
  • Pain
  • Loss of vision
  • Double vision
  • Swelling of eyelids

  • Diagnosis is made with either a CT scan or MRI and treatment is tailored individually,
    depending on the size, location and type of the tumor.

    Idiopathic Orbital Inflammation (IOI), or orbital pseudotumor, is inflammation of any area of
    the eye socket, ranging from a diffuse inflammatory process to a more localized inflammation of
    muscle, lacrimal gland or orbital fat. It has a varied clinical presentation depending on the
    involved tissue. Patients typically present with sudden painful proptosis, redness, and periocular
    swelling. Although a benign condition, it may present with an aggressive clinical course with
    severe vision loss and pain. IOI is best diagnosed with a thorough clinical exam and MRI or CT
    scan can be performed for confirmation. Oral or IV corticosteroids remain the main treatment
    modality for IOI.

    Orbital fat prolapse is a benign condition caused by weakening of orbital tissues allowing
    yellow orbital fat to become visible in the lateral corners of one or both eyes. Repair can be
    performed with a simple surgery, removing prolapsed fat and improving patient’s appearance.

    Dermoid Cyst is a cystic lesion that contains developmentally mature skin complete with hair
    follicles and sweat glands, sometimes clumps of long hair, and often pockets of sebum, blood,
    fat, bone, nails, teeth, eyes, cartilage, and thyroid tissue. Because it contains mature tissue, a
    dermoid cyst is almost always benign. It commonly appears in young children, often near the
    lateral aspect of the eyebrow. These are sometimes watched and sometimes excised. An
    inflammatory reaction can occur if the dermoid cyst is disrupted. Dermoid cysts can recur if not
    completely excised. Treatment is complete surgical removal, preferably in one piece and
    without any spillage of cyst contents.

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