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To review the clinical features, management and outcome of orbital lymphoma patients referred to the Scottish Ocular Oncology Service.

Patients with orbital lymphoma were identified by the clinical coding team and their notes were reviewed retrospectively. Data was collected on clinical features, investigations, treatment and outcome.

Seventy-eight patients were identified of which 55% were men. The average age at diagnosis was 64 years. The right orbit was involved in 49%, the left in 41% and 10% cases were bilateral. The average follow up time was 36 months. A periorbital mass was the most common presenting feature (34%) followed by eyelid swelling, diplopia and proptosis. Orbital CT was done in 76% of patients and orbital MRI in 49%. The most common location was extraconal (50%) followed by extraocular muscle (25%) and lacrimal gland (17%). An orbital biopsy was carried out in 88% of patients. MALT lymphoma was the most common subtype (31%) followed by follicular lymphoma (25%). Orbital radiotherapy was first-line treatment in 60% of the patients, chemotherapy in 32% and observation in 8%. Orbital lymphoma was the first presentation of systemic lymphoma in 36% of the patients reviewed.

Orbital lymphoma can present with non-specific symptoms and may occur bilaterally. Appropriate imaging and biopsy is essential for diagnosis. MALT lymphoma was the most common in our cohort. Relapse is common and can be late, so prolonged monitoring is advised.