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OCULAR ONTOLOGY
  • Haemangioma
A haemangioma is a tumour made up of blood vessels which can grow on the choroid, which is the layer of blood vessels beneath the retina. Choroidal haemangiomas are not malignant and do not therefore produce metastasis. However, if the haemangioma is located in the central area of vision, it can cause a leakage of liquid which leads to retinal detachment or changes of a cystic type, which cause reduced vision.
Many choroidal haemangiomas can simply be monitored by your ophthalmologist without the need for treatment. Photographs can be taken to document the evidence of leaks or growth and, according to this, start treatment. Treatment options include laser photo-coagulation to decrease the leakage of liquid, or therapy with small doses of radiation.
  • Choroidal Melanoma

Choroidal melanoma is the most common intraocular (within the eye) primary tumour in adults. Choroidal melanoma is a primary cancer of the eye. It originates in the pigmented cells of the choroid of the eye, and is not therefore a tumour which starts in other parts of the body and is spread to the eye.
Choroidal melanoma is malignant, meaning that it is a cancer which can metastasise and eventually spread to other parts of the body. Given that choroidal melanoma is an intraocular tumour and is therefore not visible, patients with this disease often fail to recognize the presence of the tumour until this grows to such a size as to reduce vision either by obstruction, retinal detachment, bleeding or other complications.
There is generally no pain except in the case of very large tumours. The best form of early detection of this lesion is carrying out periodical examinations of the retina with the pupil in dilation.

  • Eyelid tumors
Tumours of the eyelid can be benign cysts, inflammation, or malignant skin tumours.
The most common type of eyelid cancer is base cell carcinoma. Most base cell carcinomas can be surgically removed. If they are not treated, these tumours can grow around the eye and in the socket, paranasal sinuses and into the brain. A biopsy can determine whether or not an eyelid tumour is malignant. Malignant tumours are completely removed and the eyelid is repaired using plastic surgery techniques. After surgery, cryotherapy (freezing) and radiation may sometimes be required.
 
  • Iris tumours
There are tumours which may grow within and behind the iris. Although most iris tumours are cysts or moles, malignant melanomas may also appear in this area. In order to establish a comparative base, a special type of iris photography known as slit lamp photography is used. On the other hand, the only way of establishing the thickness of iris tumours is by means of high frequency ultrasound (BMU). Most pigmented tumours of the iris do not grow. These are periodically watched by means of observation and photographies.
Treatment is recommended when the growth of an iris melanoma is detected.
Most small iris melanomas can be surgically removed. For larger iris tumours, treatment options such as plate radiotherapy or nucleation are considered.
  • Lymphoma / leukaemia

Lymphomas can appear in eyelid tissue, tear ducts and within the eye. In most patients with non-Hodgkin giant cell lymphoma, the disease is limited to the eye and to the central nervous system. In these patients, symptoms appear in the eye an average of two years before appearing anywhere else. The disease itself, as well as the treatment (which may include treatment of the central nervous system with radiotherapy, chemotherapy or both), can alter the patient’s visual function.

  • Orbital Tumours.

Tumours and inflammatory processes may sometimes appear behind the eye. These tumours generally push the eye forward causing an extrusion of the eye known as proptosis. The most frequent cause of proptosis is the thyroid disease of the eye and tumours of the lymphoid tissue. Other tumours which may appear are haemangiomas (blood vessel tumours), tear gland tumours and tumours which extend from the paranasal sinuses to the eye socket. Although computerized tomography, magnetic resonance and ultrasound examinations are useful for determining the probable diagnosis, most orbital tumours are diagnosed by means of a biopsy carried out by means of an orbitotomy.

Whenever possible, orbital tumours must be removed completely. If this is not possible, or the procedure might cause too much damage to other important structures surrounding the eye, part of the tumour must be removed and sent to a pathologist to be assessed. If they cannot be surgically removed, most orbital tumours can be treated with radiotherapy. Some rare orbital tumours can require the total removal of the eye and of the contents of the eye socket. In some cases, radioactive seeds are used in the socket to treat any residual tumour tissue.

 

 

Ocular Ontology
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