Lymphoma: (1) Painless, progressive proptosis accompanied by extraocular muscle disturbances are the usual presenting signs of patients with orbital lymphoma. They may also have lacrimal gland enlargement as well as visual changes. Clinically, the lesion has a salmon-color if seen under the conjunctiva. Typically if the presenting mass is localized conjunctiva and anterior orbit, palpation reveals a rubbery, smooth lesion which is not mobile. Imaging studies depict a putty-like molding of the mass to pre-existing orbital structures without bony changes. Orbitotomy with incisional biopsy is recommended. Biopsy shows monotonous sheets of small blue cells. Systemic evaluation for other sites after disease is necessary. The majority of the lymphomas are monoclonal B cell proliferation. If the lymphoma is found to be isolated to the orbit, irradiation is needed to eradicate the tumor with excellent results. Patients should be followed periodically since systemic lymphoma can present years after having isolated orbital disease. Back to Orbit