Purpose

To describe the spectrum of biopsied orbital and orbital-adjacent pathology in a UK tertiary centre and compare patterns with published epidemiological data on orbital disease.

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Methods

Retrospective review of all orbital biopsies (2019–2026) in a single tertiary oculoplastic service, extracting demographic and clinical data.Final diagnoses were grouped into lymphoproliferative, primary and secondary malignant and benign, inflammatory and other pathologies.Descriptive statistics were compared qualitatively with the literature.

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Results

A total of 111 orbital and orbital-adjacent biopsies were analysed over the 7 year period (2019–2026) with a trend towards increasing annual biopsy rates.Lymphoproliferative and inflammatory disease were the largest groups (26/111, 23% each), followed by benign lesions (combined benign vascular and cystic/choristomatous; 27/111, 24%), primary non lymphoid malignancies (9/111, 8%) and metastatic disease (8/111, 7%).Mean age at biopsy was 67 years for lymphoproliferative lesions (range 21–85) and 69 years for metastases (52–78), compared with 49.7 years (13–77) for inflammatory disease and 43 years (3–121) for benign lesions.Benign cystic/choristomatous lesions and capillary haemangioma predominated in children, whereas idiopathic orbital inflammation, IgG4 related disease and xanthogranulomatous inflammation presented mainly in middle age, mirroring age patterns in published cohorts.The ethnic distribution reflected a multi-ethnic UK population, with lymphoproliferative disease predominating in White British patients but inflammation occured across all major ethnic groups.

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Conclusion

This series demonstrates a case-mix dominated by lymphoproliferative and inflammatory orbital disease, with age and diagnostic distributions aligning with published epidemiological reports.The prominence of IgG4 related and xanthogranulomatous entities compared with older classifications likely reflects evolving recognition and practice, highlighting the need to incorporate these diagnoses into contemporary orbital pathology frameworks.

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Additional Authors

First name	Last name	Base Hospital / Institution
Adham	Youssef	Birmingham and Midland Eye Centre
Faye	Mellington	Birmingham and Midland eye Centre

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