1. ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology ARAVIND EYE CARE SYSTEM Aravind Eye Hospital & Postgraduate Institute of Ophthalmology DEPARTMENT OF COUNSELLING Orbital Tumour

2.  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 Picture What is orbital tumour?

3. 1. 1.Benign Tumour: A tumour made up of normally functioning cells which maintain tissue boundaries is called benign. Treatment: Simple and usually curative Types of orbital tumours

4. 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

5.  Protrusion of the eye ball (proptosis)  Pain  Loss of vision  Double vision  Redness  Swelling of the eye lids  An obvious mass Symptoms

6. Investigation  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

7.  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 Treatment

8.  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 Enucleation

9.  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 Exenteration

10. Chemotherapy  It is a part of cancer management  Medicines which are active against the cancer cells are called chemotherapeutic agents or anti- cancer drugs

11. 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

12. 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

13. 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

14. 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

15.  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