What are they?
They are tumours that affect children and originate in the orbit, that is to say, in the tissue around the eye. These tumours may come from the bones, muscles, optic nerve, veins or the fat covering the tissue.
Children with orbital tumours may have one eye more protruding and open (protopsis) than the other, double vision (diplopia) and loss of vision if it affects the posterior part of the eyeball.
Causes and risk factors
Orbital tumours in paediatric age are congenital, meaning they are present from birth. No risk factors have been described.
Benign tumours in paediatric age are the most common. The benign tumours group includes dermoid cysts and vascular lesions such as capillary hemangioma and glioma of the optic nerve.
- Dermoid cysts are painless, yellowish, sack-like lumps that are firm and stretchy. They are present from birth and tend to grow slowly.
- Capillary hemangiomas are red or bluish colour lumps (depending on their depth) that usually appear a few weeks or months after birth, with quick initial growth, then they disappear on their own over the following years.
- Glioma of the optic nerve may affect one or both optic nerves, which are the nerves that carry the visual information from each eye to the brain. The manifestations of this type of tumour are due to the fact that the tumour grows and presses against the optic nerve, causing involuntary movements of the eyeball, proptosis of one or both eyes and even strabismus.
The most common paediatric malignant tumour is rhabdomyosarcoma.
- Rhabdomyosarcoma develops from the muscles. The most common symptom is proptosis of the eye. It may occur at any age, but it most frequently affects children. There are other less common lesions that affect the orbit during paediatric age.
There aren't any methods to prevent orbital tumours in paediatric age. However, we do recommend having periodic eye check-ups and seeing an ophthalmologist should you have symptoms of proptosis, diplopia or loss of vision.
The treatment for dermoid tumours is surgical removal and we usually wait until the child is at least 8 years old, unless their viual development is mechanically hindered or there is some other type of complication.
As they tend to go away on their own, capillary hemangiomas do not usually require treatment just regular check-ups. They will only require treatment if they are hindering normal eye opening and development of vision or for aestethic reasons. If the rhabdomyosarcoma can be resected, it is operated on and then orbital chemotherapy or radiotherapy will be administered.
Frequently asked questions
If my 2-year-old has one eye more open and larger than the other, what should I do?
With regard to any symptoms, you should see an ophthalmologist for a full examination and they will probably request a CT (computerised tomography) or MRI (magnetic resonance imaging) scan to rule out lesions of the orbit.
My 4-year-old daughter has a capillary hemangioma. After taking her to see about a droopy eyelid, they've recommended surgery. Is that the right thing to do?
Yes, although this type of lesion usually disappears, if it means that your daughter's vision may not develop properly, then it would be best to have it treated.