Orbital Lymphoma

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Orbital lymphoma could present like a chronic unilateral conjunctivitis resistant to treatment

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Features:

• Slowly progressing, painless orbital process
• Salmon pink conjunctiva (may be mistaken for conjunctivitis pinkish tinge)
• Mass (if present) may be S shaped in the lacrimal gland (lateral)
• Mass (if present) may cause ptosis if involving superior orbital and levator muscle
• Eyelid swelling and double vision are common complaints

Differentials:

• Epithelial tumour
• Inflammatory / infection

Management:

• Radiation
• Chemo (not indicated unless systemic lymphoma)
• Surgery for biopsy and histology
• Cryotherapy may be beneficial