Metastatic tumors to the orbit occur in both children and adults and can be the presenting sign of systemic malignancy. The most common presenting signs and symptoms are eyelid edema, red eye, diplopia, vision loss, pain, strabismus, and proptosis. The presentation of orbital metastases generally depends on the position of the tumor and which structures, such as cranial nerves, the tumor compresses.

In children, neuroblastoma and leukemia are the most common primary tumors. In adults, breast, lung, and prostate carcinoma are the most frequently seen primary tumors, but any primary tumor can metastasize to the orbit. Vision and pupils should be checked in any orbital process. Metastatic tumors have been known to cause ptosis, myosis, and anhidrosis (Horner syndrome), so close examination of the pupil is necessary.

Orbital metastases are generally associated with a poor prognosis, and one study found an average survival of 1.5 years after diagnosis, independent of primary tumor type.

Related topic: Metastatic tumors to the choroid