The area between the back of the eye and the brain is called the orbital apex. There are multiple nerves in the orbital apex that may be affected by tumor growth. Symptoms may include decreased visual acuity (sharpness), muscle impairment causing drooping of the eye, pain, or protrusion (sticking out) of one or both eyes. A visual examination, MRI with contrast, and CT are all used to help diagnose these tumors. In some instances, an angiogram may be used to evaluate the blood vessels in the area.
If surgery is recommended, the location of the incision (approach) will depend on where the tumor is located behind the eye. Options may include an incision in the conjunctiva/lower eyelid, a couple millimeters below the bottom eyelashes, through the roof of the mouth, through the nose, through the upper eyelid, or through the eyebrow.