Download Orbital tumour

DEPARTMENT OF COUNSELLING
Orbital Tumour
ARAVIND EYE CARE SYSTEM
Aravind Eye Hospital
& Postgraduate Institute of Ophthalmology
What is orbital tumour?
 An abnormal, uncontrolled growth of cells in
any body tissue results in a mass of cells. This
is called a tumour
 Tumour when present in the orbit are called
orbital tumours
 It can attack adults are children
 It may also spread from other areas of the body
Picture
Types of orbital tumours
1. Benign Tumour:
A tumour made up of normally
functioning cells which maintain tissue
boundaries is called benign.
Treatment: Simple and usually curative
2. Malignant Tumour:
 A malignant tumour or cancer is one which is
made of cells that have the potential to invade
& destroy surrounding structures
 Cancer cells can spread to other body parts and
start new tumours there
Treatment: Generally multi dimensional and may
not be curative
Symptoms
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Protrusion of the eye ball (proptosis)
Pain
Loss of vision
Double vision
Redness
Swelling of the eye lids
An obvious mass
Investigation
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Ultra sound
CT scan or MRI
Blood Test
Lumbar puncture
Bone marrow testing
Do the Biopsy test to know whether it
is benign or cancerous
Treatment
 Treatment of orbital tumours varies depending
on the size, location and type
 Some types of orbital tumours require no
treatment, while others are best treated
medically or with the use of radiation therapy
or chemotheraphy
 Still others may need to be totally removed by
either an orbital surgeon or a neuro surgeon
depending on the particular case
Enucleation
 It is the surgical removal of the
diseased or damaged eye ball
 In this procedure the muscles outside
the eyeball and the other orbital
structures are left
Exenteration
 It is the surgical removal of the
diseased eye ball along with the orbital
structures
 It is performed for tumours of the eye
ball which have spread outside the eye
or for the recurrent tumours
Chemotherapy
 It is a part of cancer management
 Medicines which are active against
the cancer cells are called
chemotherapeutic agents or anticancer drugs
Side effects of Chemotherapy
 An anti-cancer drugs are effective against all
rapidly dividing cells
 They also kill normal body cells which are rapidly
divining such as, hair follicle, lining cells of the
bowel, immune cells
 Loss of hair, bowel disturbances, frequent
infections
 These drugs are given in a cyclic fashion, repeated
once in three weeks
Radiotherapy
 It is a part of armamentarium used to fight against
cancer cells
 High energy rays such as X-rays, rays, neutrons, and
the other sources are used to kill cancer cells and
reduce the tumour
 Radiation may come from an outside source (External
beam RT) or the source may be placed close to the
tumour (Brachytherapy)
 It is given over a period of time divided into equal
doses
Side effects of Radio therapy
 They are similar to chemotherapy, but
it mainly has local side effects
 Skin changes, conjunctivitis, dry eyes,
cataract formation, and damage to
retina or optic nerve
Role of counsellor
 Counsellor approach should combine compassion and
firmness
 Convince the patient in a sympathetic manner
 Explain about the types of tumour and the necessary of
treatment
 Counsellor should understand that if destructive,
surgery had been advised, the family would probably
be in shock and would need some time to accept this
 It should be patiently explained that this is the only
option available and is being done to prevent further
harm to the patient
 Removal of the eye means vision in that eye will not be
restored by any other method
 However an artificial eye can be placed later, which will
at least provide the appearance of a normal eye
 In case of tumours with familial occurrence (like retino
blastoma), the patients should be clearly instructed to
bring the sibling for examination & genitic counselling
should be done