Tumors of the Orbit

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TUMORS of the orbit are not uncommon and must be suspected in every patient with exophthalmos, especially if the condition is unilateral. Benign tumors are the most frequent and include hemangioma, pseudotumor, meningioma, dermoid cyst, osteoma, neuroma, and lipoma. The malignant growths are sarcoma, carcinoma (frequently of the lacrimal gland), lymphoma, leukemic infiltrations, and tumors of the optic nerve.

Clinical Manifestations

The most consistent finding in patients with orbital tumors is exophthalmos, which may be a straight forward protrusion if the growth arises within the muscle cone of the eye or a lateral or vertical displacement if the tumor arises from outside this area. Tumors arising in the anterior half of the orbit usually displace the globe to the opposite side and may produce little or no real exophthalmos. The amount of forward displacement of the eyeball can readily be measured with a Hertel’s exophthalmometer; 1 5 - 20 mm. is usually considered normal. Pain is not a common symptom, and congestion of the conjunctiva occurs but rarely, although it may be present in vascular tumors.

Diplopia resulting from proptosis and the resulting immobilization of the eye may not be apparent to the patient because of visual impairment of the affected eye. Visual field defects and loss of visual acuity occur early in tumors invading the optic nerve or optic canal and may occur later in tumors of other parts of the orbit that produce pressure on the optic nerve or globe due to their increased size.


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