Orbital Pseudotumor: What It is and What to Do

The purpose of this paper is to provide an overview of the diagnosis and management of orbital pseudo-tumor. Orbital pseudotumor is a benign, non-infective, protean clinical syndrome of unknown etiology characterized by inflammation of the orbit. Patients with orbital pseudotumor often present with redness, edema, or pain. More serious manifestations such as proptosis, motility limitations, optic nerve compression, and even visual loss, suggest the presence of a space-occupying or infiltrative lesion. Orbital pseudotumor is considered a diagnosis of exclusion. A complete evaluation includes careful history taking, detailed physical examination, neuroimaging, biopsy, and hematologic testing. After an initial biopsy, when feasible, patients are first treated with non-steroidal anti-inflammatory drugs (NSAIDs) and/or cortico-steroids or radiation. When this is inadequate, patients may consider other options such as chemotherapy, immunosuppressants, or surgery. The goal of treatment is to ensure proper symptom control and to optimally maintain orbital structure and function