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Orbital granuloma

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This is an immune mediated disorder of the orbit caused by a diffuse granulomatous infiltrate of lymphocytes and plasma cells in the orbital fat and external ocular muscles.

Features:

  • sudden onset of orbital pain with lid oedema
  • proptosis
  • chemosis
  • ophthalmoplegia

It usually occurs in middle age and is rarely bilateral.

CT reveals a diffuse orbital lesion which may be confirmed by biopsy.

Treatment is initially by steroids eg. prednisolone. If this is unsuccessful, try radiotherapy.


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