Bulging eye: What to do when you have a tumor of the eye socket

The most common cause of a bulging eye in the eye socket is Graves disease, an autoimmune disease that causes the eye muscles and fat to increase in size. However, the more serious cause of bulging of the eyes are tumors or growths. There are two types of tumors of the eye socket:

Benign Tumor

Malignant Tumor

A benign tumor is one that grows in the eye socket but doesn’t spread to the rest of the body like a malignant tumor. In general, malignant tumors are much worse than benign tumors because they can spread to your brain, lung and bod and kill you. The most common orbital tumor that is benign is a cavernous hemangioma which is a ball of blood vessels. It can spread in the eye socket and damage the eye and surrounding structures.

The most common malignant tumor is metastasis or cancer that has spread from somewhere else in the body like lung cancer, breast cancer or prostate cancer. The second most common tumor that is not from another part of the body is lymphoma. Malignant tumors need to be treated either with radiation, chemo, or both. The body needs to be checked for spread of cancer unlike a benign tumor of the orbit like a hemangioma.

What are the risks of removing a tumor from the orbit?

The risks of tumor removal include but are not limited to:

Vision loss Double vision

Dilated pupil

Need for more surgery

Bleeding Scarring

Infection

Let’s discuss the two big risks:

Anytime we operate in the orbit there are risks to loss of vision despite all the care and planning of the surgery. The most common method of vision loss is via damage to the optic nerve but also there can be other risks such as retinal injury or damage to the cornea.

Double vision is a well known risk of orbital surgery. As a tumor is removed, the eye sits in a different position in the eye socket which can cause double vision. Also, the eye muscles can be temporarily or permanently stretched from the surgery in the orbit. Many patinets may need double vision surgery after orbital surgery.

How is eye socket surgery performed?

Eye socket surgery is performed in the operating room under general anesthesia. The patient has nothing to drink or eat by mouth and definitely needs a ride to come with them. Having eye socket surgery is a whole day affair.

What is the recovery from eye socket surgery?

Eye socket or orbital surgery requires 1 to 2 weeks of recovery which includes rest, no nose blowing, no bending, no lifting, and no exercise. Swelling and bruising take two weeks roughly to improve. Other issue like healing and double vision may take 6 months to improve.

Dr Thiagarajah is a neuro-ophthalmologist and orbital surgeon. He has expertise in adult double vision, optic nerve issues and surgery in the eye socket. His area of expertise is eyelid surgery, eye socket surgery and tear duct surgery.