Recent Developments in the Management of Orbital and Periocular Neoplasms

Orbital and periorbital malignancies account for a significant proportion of cancers in ophthalmic oncology, encompass a wide variety of histologies, and are more frequently encountered than intraocular tumors. In this chapter, we focus on the major types of orbital and periorbital cancers: lymphoma, melanoma, squamous cell carcinoma, basal cell carcinoma, and lacrimal gland tumors. Treatments are often multidisciplinary and aim to eliminate cancer with the least ocular morbidity possible. Surgery remains the mainstay treatment; however, newer medical treatments such as immunotherapy and targeted biologic treatments have been a welcome addition for locally advanced and metastatic disease. For low-grade ocular adnexal lymphoma, significantly lower doses of radiation compared with “standard dose” have demonstrated good efficacy, lowering the morbidity and cost associated with radiotherapy. Finally, perspectives on sentinel node biopsy for detection of early microscopic disease associated with eyelid cancers and multidisciplinary eye-sparing treatments for lacrimal gland carcinomas will be highlighted.