Eye tumour larger than eyeball surgically removed at Medcare Hospital Sharjah

DUBAI: A routine eye examination prevented a 57-year-old Filipina resident of Sharjah from going blind for the rest of her life. The expat had been suffering from vision loss and heaviness around her right eye for almost a month when she went to see an ophthalmologist.

Further, she was referred to Oculoplasty and Orbit Surgery specialist at Medcare Hospital Sharjah, who discovered a large tumour in the orbit of the eye, and recommended additional examination. A massive tumour measuring 35x30mm, larger than the patient’s 24mm eyeball, was successfully removed at Medcare Hospital in Sharjah following a strenuous hour long complex surgical procedure.

The astute ophthalmologist at Medcare Hospital Sharjah noticed that the patient’s right eye protruded more than the left during the eye checkup. The patient insisted that it was a slowly progressive protrusion that began to show since her childhood. Following the ophthalmologist’s timely prognosis, the patient got an MRI and CT scan done, where the medical team discovered a well-defined oval intraconal lesion in the right orbit, indicating the likelihood of a cavernous hemangioma (vascular tumour). The patient underwent a highly sophisticated micro invasive surgery, which is thought to be the first of its type in Medcare, to remove the tumour from behind her eye.

Cavernous hemangioma is a benign vascular tumour often discovered in the middle age. It is one of the most common benign tumours that grows in the orbit of the eye. It is known to grow slowly, but when situated in critical areas near the optic nerve it can lead to vision loss or blindness in the long run. In this case, the tumour was compressing the optic nerve, threatening the patient’s sight.

Dr. Fairooz P.M., Oculoplastic Surgeon at Medcare Hospital Sharjah, who is also an eye cancer specialist leading the surgical team stated, “This was a very risky case as it was compressing the optic nerve causing vision loss, and the surgical procedure involved protecting the optic nerve to regain the vision. This meticulous surgery, which required a high level of precision, was crucial in preventing further vision deterioration.”

Prior to the surgery, the tumour caused the eye to protrude forward and threatened her vision by squeezing the nerve at the back of the eye. It was a micro incision internal orbital surgical approach that was adopted, Dr. Fairooz stated.

According to Dr. Fairooz, the benign tumour measured 35x30mm, which was larger than the patient’s 24mm eyeball. Despite not spreading to other areas of the eye, the tumour continued to grow in size, abutting the optic nerve and compressing it, pushing it to the orbital walls, resulting in compressive optic neuropathy.

Highlighting the critical nature of this case, Dr. Fairooz said, “Cavernous hemangioma is among the most common orbital tumours, representing 20 percent of all orbital masses. While these tumours are usually painless and grow slowly, they can pose serious challenges when located near crucial structures like the optic nerve, potentially threatening vision”.

The diagnosis and management of orbital tumours, particularly those impacting visual function, pose significant challenges to surgeons. In such cases, timely and precise intervention is crucial to prevent serious complications, such as vision loss.

Following the complicated procedure, her vision was completely restored.

Reflecting on the outcome, Dr. Fairooz extended gratitude to the whole team for a combined efforts that rendered the treatment successful. She added: “We are very pleased that the patient responded well to the surgery and has fully recovered. The bulge was in fact the symptom that indicated the tumour’s presence, making it a crucial component of the diagnosis. The pressure on the optic nerve was more harmful and threatened the patient’s vision”.

“We believe this is the first time such a procedure has been carried out by the Oculoplasty and Orbit Surgery Department at Medcare, and we are delighted with the patient’s recovery,” added Dr. Fairooz.

The multidisciplinary approach taken by Medcare Hospital in Sharjah was key to the success of this complex procedure. The collaborative efforts of the oculoplastic surgeon and radiologists resulted in a precise diagnosis. A well-executed treatment plan using the advanced imaging techniques, cutting-edge surgical methods and skilled operation theatre staffs became instrumental in achieving a positive outcome for the patient, while demonstrating the hospital’s expertise in managing such challenging cases.