Orbital Disease in St. Petersburg & Clearwater
The orbit, the bony socket surrounding the eye, can be affected by many medical and surgical conditions. Tampa Bay Cosmetic Surgery Center offers expert diagnosis and treatment for the full range of orbital problems.
Orbital Fracture
Trauma may cause fracture of the orbital bone surrounding the eye. If untreated, such fractures may result in facial deformities or double vision.
Blunt trauma to the eye and surrounding bones, such as by a fist, can lead to a fracture in the thin bones of the orbit behind the eye. Anyone with such an injury should seek a complete eye examination promptly to rule out other eye injury. The floor and inside wall of the orbit are especially thin, with sinuses on the other side of the bone. Blunt trauma can cause a “blow-out fracture,” where a sudden rise in orbit pressure blows a fracture through the bone and into the sinus. If this involves the orbital floor, the cheek below the eye and upper gums in the mouth can often become numb due to damage to a sensory nerve running through the floor of the orbit.
If the fracture is large enough, orbital contents can start slipping into the sinus, and the eye will appear to sink backward. Sometimes an eye muscle becomes trapped in an orbital fracture, leading to double vision, especially when looking up, with pain. A CT scan of the orbit can diagnose fractures and muscle entrapment, and entrapped muscles often must be released surgically. Antibiotics are usually given after an orbital fracture due to infection risk from the sinus into the orbit.
Orbital Inflammation (Orbital Infection or Orbital Cellulitis)
An infection of the bony eye socket can lead to severe symptoms, including double vision. Orbital infection usually spreads from adjacent sinuses, and sometimes from a skin or eyelid infection. Symptoms include pain, eyelid swelling and possibly a lump behind the eyelids, eye and eyelid redness, discharge, blurred vision, eye displacement or protrusion, and double vision. The double vision comes from the infection preventing normal eye movement, with misalignment occurring in certain positions of gaze. Patients with this condition are usually treated in the hospital with IV antibiotics. Diabetics are subject to a particularly severe and destructive fungal orbital cellulitis.
Orbital pseudotumor, meaning “like a tumor,” is an inflammatory condition that can simulate tumor or infection but usually responds to steroids. A CT scan or MRI is typically done in cases of orbital infection, tumor, or pseudotumor to help make the diagnosis and guide treatment.
Orbital Tumors
Tumors may develop in any of the tissues within the orbit and may also invade from the sinuses, brain, or nasal cavity, or metastasize from other areas of the body. Orbital tumors can affect adults and children, though fortunately most are benign.
What Are the Symptoms of an Orbital Tumor?
Symptoms may include protrusion of the eyeball (proptosis), pain, loss of vision, double vision, redness, swelling of the eyelids, or an obvious mass. Some tumors are visible and easily identified, while others show no symptoms until large enough to displace the eyeball. Prominence of the eyes isn’t necessarily the result of a tumor and may instead result from inflammation such as that caused by Thyroid Eye Disease. In children, parents may first notice a droopy eyelid or slight eye protrusion.
Orbital tumors are most frequently diagnosed with a CAT scan or MRI, and a biopsy may follow if either test looks suspicious.
How Are Orbital Tumors Treated?
Treatment varies depending on the tumor’s size, location, and type. Some require no treatment, while others are best treated medically or with radiation therapy. Others may need total removal by an orbital surgeon or neurosurgeon, depending on the case, with additional radiation or chemotherapy sometimes required afterward. Surgery has become much safer because CAT scans and MRI testing help pinpoint tumor location and size.
Final Reminders
Effectively treating the many varied conditions of the orbit requires special understanding of orbital anatomy and pathophysiology. Fellowship in the American Society of Oculofacial Plastic and Reconstructive Surgery (ASOPRS) indicates the surgeon has the greatest specialized training and expertise in treating orbital problems.
If you have problems related to the orbit, schedule a consultation with Dr. Kass at the Tampa Bay Cosmetic Surgery Center for Cosmetic Facial & Eye Plastic Surgery, who is fully trained to treat these problems and has practiced for over 30 years.
Orbital Disease FAQs
What is the orbit and what does it contain?
The orbit is the bony socket surrounding the eye, containing the eye, arteries, muscles, and nerves, cushioned by supporting membranes and fat.
What causes an orbital fracture?
Blunt trauma, such as from a fist, can cause a “blow-out fracture” in the thin bones of the orbit, sometimes requiring surgical repair of trapped eye muscles.
What are the symptoms of orbital infection?
Symptoms include pain, eyelid swelling, redness, discharge, blurred vision, eye displacement, and double vision, often requiring hospital treatment with IV antibiotics.
Are orbital tumors usually cancerous?
Fortunately, most orbital tumors are benign, though treatment varies by size, location, and type.
How are orbital tumors diagnosed?
Orbital tumors are most frequently diagnosed with a CAT scan or MRI, with biopsy performed if results look suspicious.
Can eye prominence be caused by something other than a tumor?
Yes, eye prominence can result from inflammation such as Thyroid Eye Disease rather than a tumor.
Why does orbital disease require a specialized surgeon?
Effective treatment requires special understanding of orbital anatomy, best provided by a fellowship-trained oculofacial plastic surgeon.