Ocular Tumors

What are ocular tumors?

Ocular tumors are all those diseases that affect the eyelids, eye and orbit. These types of lesions can be benign or malignant. In most cases they are benign, but tumors can increase in size over time and cause eye problems due to compression of other structures in the area.

Among intraocular tumors, the main ones are:

  • Melanoma
  • Retinoblastoma, occurring in childhood.
  • Choroidal hemangioma
  • Orbital tumors

Prognosis of the disease

Each type of ocular tumor has a different prognosis:

Intraocular tumors include melanoma can occur in various tissues, although that of choroidal location (choroidal melanoma) is the most common malignant primary intraocular tumor in the adult.

Retinoblastoma is very aggressive and, therefore, it is essential to diagnose and treat it early. Choroidal hemangioma is benign but spreads rapidly and can alter vision, since its growth threatens the optic nerve. Orbital tumors are the least frequent and do not have specific causes.

Retinoblastoma is an eye tumor that affects mostly in childhood.

Symptoms of eye tumors

Most eye tumors are usually asymptomatic and may initially go unnoticed. Eyelid tumors are manifested by the appearance of lumps or lesions that cause eye discomfort, while orbital tumors are manifested by eye pain or alterations, decreased vision or displacement of the eyeball (proptosis or exophthalmos).

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One of the most characteristic symptoms of an orbital tumor is exophthalmos, i.e. bulging eyes. Eye movements may also be affected and may result in double vision.

Tumors affecting the optic nerve may alter vision more rapidly. Pain is a less frequent and more typical symptom of orbital inflammation and/or infection.

There may be eyelid changes, such as eyelid swelling (edema) or redness of the eyelid (erythema), which are typical of infectious and/or inflammatory processes and some tumors. The eyelid may also be more retracted, as in thyroid ophthalmopathy, or more droopy (palpebral ptosis).

Medical tests for ocular tumors

An ophthalmologic examination with an ophthalmoscope may reveal a simple oval or round growth (tumor) in the eye. Tests that may be ordered include:

  • CT scan or MRI of the brain to look for spread (metastasis) to the brain
  • Ultrasound of the eye
  • Skin biopsy if there is an area of skin involved.

What are the causes of eye tumors?

Some tumors are congenital, such as 50% of retinoblastomas, which are transmitted from one generation to the next and affect 1 in 15,000 newborns. Others, such as intraocular melanomas, have no specific risk factors. Some may be associated with a syndrome or may be secondary, spread from adjacent territories or due to a process of metastasis.

Can they be prevented?

Intraocular tumors cannot be prevented, but it is possible to diagnose them early. It is therefore advisable to have a routine annual fundus examination after the age of 50, the age at which they most commonly begin to appear.

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In addition, since malignant lesions can recur over time, it is important that once treated, periodic follow-up is performed.

Treatments for ocular tumors

Treatment depends on the type of tumor, its classification, size and location within the globe,

Benign tumors are usually treated with periodic check-ups and imaging tests on a routine basis, unless they cause loss of vision or other problems involving the eyeball, in which case the treatment would be surgical removal of the tumors.

Malignant tumors are usually completely removed. Surgery for these tumors is delicate and is performed through small incisions in the eyelid skin (in the natural folds of the eyelid) or through the conjunctiva. Only very rarely does the treatment lead to the loss of the eyeball and all the structures of the orbit (orbital exenteration).

In other cases the treatment is systemic with radiotherapy and/or chemotherapy.

It is important to evaluate each case individually to make the most appropriate decision.

Which specialist treats it?

All ocular tumors require a thorough early evaluation by an ophthalmologist.