Common Orbital Disorders in Adults

  • Kelvin Kam Lung ChongEmail author
  • Ardining Sastrosatomo
  • Shasha Liu
  • Matthew Chun Wah Lam


Orbital lesions in adults (VEINS: vascular, endocrine, inflammatory/infective, neoplastic, structural) range from a simple cyst to life-threatening disorder. They may cause ocular discomfort, visual dysfunction and/or periorbital disfigurement. A step-by-step evaluation starts with history-talking focusing on patients’ chief complaints, eliciting relevant ocular and orbital signs to arranging radiological, histological and systemic investigations. A multidisciplinary team involving ophthalmologists, radiologists, histopathologists, oncologists and neurological, plastic or ENT surgeons are often required to manage many challenging orbital conditions.


Orbit Orbital tumors Dermoid cysts Orbital vascular lesions IgG-4 related ophthalmic disease Optic nerve meningioma Orbital metastasis Cavernous hemangioma Orbital cellulitis Orbital trauma 




Vascular (Orbital vascular malformation)

Type 1, 2, 3



Endocrine (TED)


Inflammation: IOID, IgG4ROD




Lymphoproliferative diseases: OAL vs LH

Lacrimal gland tumors: epithelial vs mesenchymal vs metastatic

Mesenchymal tumors



Suggested Readings

  1. 1.
    Rootman DB, Heran MK, Rootman J, et al. Cavernous venous malformations of the orbit (so-called cavernous haemangioma): a comprehensive evaluation of their clinical, imaging and histologic nature. Br J Ophthalmol. 2014;98(7):880–8.CrossRefGoogle Scholar
  2. 2.
    Jianhua Yan & Zhongyao Wu. Cavernous hemangioma of the orbit: analysis of 214 cases. Orbit. 2004;23(1):33–40. Scholar
  3. 3.
    Rosenbaum J, Choi D, Harrington C, Harris G, Czyz C, White V, et al. Identifying and classifying nonspecific orbital inflammation (NSOI) by gene expression array. Invest Ophthalmol Vis Sci. 2013;54:2035.CrossRefGoogle Scholar
  4. 4.
    Avni-Zauberman N, Tripathy D, Rosen N, Ben Simon GJ. Relapsing migratory idiopathic orbital inflammation: six new cases and review of the literature. Br J Ophthalmol. 2012;96(2):276–80.CrossRefGoogle Scholar
  5. 5.
    Mombaerts I, Bilyk JR, Rose GE, et al. Consensus on diagnostic criteria of idiopathic orbital inflammation using a modified delphi approach. JAMA Ophthalmol. 2017;135(7):769–76.CrossRefGoogle Scholar
  6. 6.
    Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol. 2012;22:21–30.CrossRefGoogle Scholar
  7. 7.
    Goto H, Takahira M, Azumi A, et al. Diagnostic criteria for IgG4-related ophthalmic disease. Jpn J Ophthalmol. 2015;59:1–7.CrossRefGoogle Scholar
  8. 8.
    Wu A, Andrew NH, McNab AA, et al. IgG4-related ophthalmic disease: pooling of published cases and literature review. Curr Allergy Asthma Rep. 2015;15:530.CrossRefGoogle Scholar
  9. 9.
    Garcia GH, Harris GJ. Criteria for nonsurgical management of subperiosteal abscess of the orbit: analysis of outcomes 1988-1998. Ophthalmology 2000; 107:1454-6. Discussion 1457–8.Google Scholar
  10. 10.
    Dewan MA. Orbital cellulitis with subperiosteal abscess: demographics and management outcomes. Ophthal Plast Reconstr Surg. 2011;27(5).Google Scholar
  11. 11.
    Hill RH 3rd, Shiels WE 2nd, Foster JA, Czyz CN, Stacey A, Everman KR, Cahill KV. Percutaneous drainage and ablation as first line therapy for macrocystic and microcystic orbital lymphatic malformations. Ophthalmic Plast Reconstr Surg. 2012;28(2):119–25.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Kelvin Kam Lung Chong
    • 1
    Email author
  • Ardining Sastrosatomo
    • 2
  • Shasha Liu
    • 3
  • Matthew Chun Wah Lam
    • 4
  1. 1.Department of Ophthalmology and Visual Science, Faculty of MedicineThe Chinese University of Hong KongKowloonHong Kong
  2. 2.Jakarta Eye CenterJakartaIndonesia
  3. 3.United Christian HospitalKwun TongHong Kong
  4. 4.Hong Kong Eye HospitalHo Man TinHong Kong

Personalised recommendations