Patient usually present with eyelid swelling or bulging eyes (proptosis or exophthalmos). In some rare circumstances, the eyes may look red. Patient may also complains of sudden development of double vision (diplopia). Patient may or may not feel painful. The duration of disease may be in terms of weeks or even year. The orbital tumour may be benign ( not cancerous ) or cancer. It is very important that CT/ MRI is being done to identify the location of the lesion. However, biopsy is often required to establish the nature of the lesion. Empirical use of steroid is dangerous and may delay the proper diagnosis of the lesion.
It is important to perform CT scan or sometimes MRI to identify extent of lesion and sometimes able to identify the nature of the disease. Biopsy is usually required to establish diagnosis. Further treatment usually depending on diagnosis.
Common pathologies and treatment is as follow:
a) Dermoid cyst: Can be completely excised without complication
b) Orbital meningioma : Usually debulking is possible
c) Orbital lymphoma: Incisional biopsy and subsequent chemotheraphy is required.
The list is non exhaustive. It is important that the patient need to seek attention of oculoplastic surgeon as early as possible to avoid further complication.
Pre op: This patient has bilateral enlarged lacrimal gland. CT scan showed enlarged bilateral lacrimal gland. Incisional biopsy showed MALT lymphoma. He subsequently has chemotherapy.
Pre op: Right orbital cyst
Post op: Post excision of orbital cyst
Pre op: Doctor, do I have cancer? No, you don't. This lump usually alarm patient. However, there are just prolapsed orbital fat.
Post op: Post removal of orbital fat, the eyes look much better and dry eyes symptoms improved.