An individual experiencing symptoms of an orbital tumor is likely to consult either their primary physician or an eye doctor first. An ophthalmoscope (the handheld device your doctor uses to look into your eyes) allows a view into the back of the eye and reveals details that may suggest the presence of a tumor. Immediate referral to an orbital tumor specialist is critical, so that the tumor can be confirmed and a treatment plan developed.
An individual with a suspected orbital tumor will likely be sent for an MRI or CT scan to determine the location and size of the tumor, and exactly what kind of tumor it is (such as hemangioma, sarcoma, or meningioma) These scans are the first diagnostic tools and often allow doctors to make an exact diagnosis. In some cases, a surgical biopsy may be necessary to identify the tumor type accurately. An experienced neurosurgeon is often able to remove the entire tumor during the biopsy.
Depending on the individual circumstances, an orbital tumor may be treated with:
Stereotactic radiosurgery, a non-invasive procedure in which highly focused beams of radiation are directed at the tumor to destroy it. (Find out more about Stereotactic Radiosurgery at Weill Cornell Medicine Neurological Surgery.)
Chemotherapy, in which cancer-fighting drugs are delivered into the bloodstream (either in pill form or IV drip) to seek out and destroy cancer cells. New advances in Interventional Neuroradiology have made it possible to deliver tumor-fighting drugs directly to the site of certain tumors, including retinoblastoma, using super-selective intra-arterial infusion. In this procedure, the drug is not put into the bloodstream, but threaded through a tiny catheter and infused to the tumor itself, which avoids the whole-body toxicity of chemotherapy. (More about intra-arterial chemotherapy for retinoblastoma.)
Surgery to remove the tumor. The orbit is a complex and delicate structure, so the surgery should only be performed by experienced surgeons with advanced training in treating orbital tumors. (See more about Surgery for Orbital Tumors.)
Orbital tumors are significant challenges even when they are small and/or benign, since they threaten vision and facial appearance. These complicated cases are not for community hospitals — they should be seen and treated at major medical centers with experts from multiple specialties who have experience in orbital tumors.
Reviewed by: Philip E. Stieg, M.D., Ph.D.
Last reviewed/last updated: October 2020