Will I always need surgery?

No, many orbital lesions can be observed or treated medically. The role of orbital surgery is often diagnostic biopsy first, followed by definitive treatment that may not be surgical.

Will I need imaging beforehand?

Almost always. MRI and/or CT is essential to plan any orbital procedure, and is usually part of the initial work-up before referral.

How is decision-making made?

Orbital tumours are managed in a multidisciplinary setting. I work closely with neuroradiology, oculoplastic colleagues at regional centres, and oncology where appropriate.

Orbital

Orbital tumours

Diagnosis and surgical management of tumours within the eye socket, from benign lacrimal-gland lesions to lymphoma, vascular lesions and rare malignancies.

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Summary

The eye socket (the orbit) contains the eye, the muscles that move it, the optic nerve, fat, blood vessels and the lacrimal gland, all packed into a confined bony space. Tumours of any of these tissues can present as bulging of the eye, double vision, pain, or a visible lump. Orbital surgery for these lesions is precise, imaging-guided work performed by a small group of subspecialists.

Who is this for?

Patients I commonly see:

a slow- or rapidly-progressive proptosis (bulging eye) on one side,
a palpable mass in the upper outer orbit (often a lacrimal-gland lesion),
an MRI finding of an orbital lesion needing biopsy,
patients with a known systemic condition (lymphoma, IgG4-related disease, granulomatosis) being investigated for orbital involvement,
vascular lesions causing distortion of the eyelid or eye position.

What the procedure involves

Procedures are individualised. Common operations include:

Anterior orbital biopsy: for accessible lesions in the front of the orbit, via a small lid incision under local or general anaesthetic.
Lateral orbitotomy: a discreet incision at the outer corner to access the lateral orbit and lacrimal gland.
Medial orbitotomy: via a transcaruncular or ‘open’ approach for medial lesions.
Joint procedures with skull-base surgical colleagues: for deep lesions approaching the optic canal.

Pre-operative imaging is reviewed in detail and the procedure is planned to maximise diagnostic yield while minimising risk to the eye and optic nerve.

Recovery and what to expect

An overnight stay is common after orbitotomy.
Bruising and swelling for 1–2 weeks.
Sutures removed at 7 days.
Histology results and a management plan typically take 2–3 weeks.

Risks and alternatives

Orbital surgery has small but important risks: bleeding, double vision, ptosis, numbness, scarring, and very rarely visual loss. Each procedure is planned to keep these risks to a minimum.

Many lesions can be observed or biopsied minimally rather than excised; the decision is always individualised.

Thyroid eye disease

A complete pathway for thyroid eye disease, from medical management of active inflammation to orbital decompression, squint surgery and eyelid surgery in the rehabilitation phase.

Make an enquiry.

Private consultations are arranged through Gina Stacey, my secretary. NHS appointments are by GP referral via Portsmouth Hospitals University NHS Trust.

Private secretary

Gina Stacey

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NHS

NHS appointments at Queen Alexandra Hospital are arranged via your GP or optometrist through Portsmouth Hospitals University NHS Trust.

In an emergency

For urgent eye problems please call NHS 111, attend the on-call eye casualty service, or call 999 if it is life-threatening.