Orbital Eye Disease

Orbital Inflammatory Disease (OID), also known as orbital inflammatory pseudotumour, is a condition that affects the tissues surrounding the eye. It is an important yet often misunderstood cause of eye pain, swelling, and visual disturbance. As a consultant ophthalmologist, I believe that early recognition and treatment are key to preventing long-term complications.

What Is Orbital Inflammatory Disease?

OID refers to inflammation of the soft tissues within the orbit — the bony socket that houses the eye. Unlike infections or cancers, orbital inflammation is not caused by bacteria, viruses, or tumours. Instead, it is typically due to an autoimmune response, where the body's immune system mistakenly attacks its own orbital tissues.

Who Is Affected?

Orbital inflammatory disease can occur at any age but is more commonly diagnosed in adults, particularly in middle age. It affects both men and women and may present in one or both eyes.

Symptoms to Watch For

OID usually has a sudden onset, and symptoms can vary depending on which part of the orbit is inflamed. Common signs include:

• Pain around the eye or deep within the socket

• Swelling of the eyelids or tissues surrounding the eye

• Redness and tenderness

• Double vision (diplopia) due to restricted eye movement

• Bulging of the eye (proptosis)

• Reduced vision in more severe cases

These symptoms can sometimes mimic those of more serious conditions such as orbital cellulitis or orbital tumours, which is why professional evaluation is essential.

Causes and Associated Conditions

In many cases, the exact cause of orbital inflammatory disease remains unknown. However, it is often associated with systemic autoimmune diseases such as:

• Thyroid eye disease (Graves' orbitopathy)

• Sarcoidosis

• Granulomatosis with polyangiitis

• Rheumatoid arthritis

Sometimes, the inflammation is confined to the orbit alone — known as idiopathic orbital inflammation — with no identifiable systemic cause.

Diagnosis

Diagnosis involves a combination of:

• Detailed clinical examination

• Imaging studies (MRI or CT scans) to assess the extent and nature of the inflammation

• Blood tests to rule out infection or systemic inflammatory conditions

• Biopsy in uncertain cases, to exclude malignancy

  
  

Treatment Options

The mainstay of treatment is anti-inflammatory therapy, particularly:

• Oral corticosteroids – These typically bring rapid relief, but careful monitoring is required to manage side effects.

• Immunosuppressive medication – Used when steroids alone are insufficient or not well tolerated.

• Radiotherapy or surgery – Occasionally used in persistent or recurrent cases.

Importantly, the treatment plan is highly individualised, depending on the patient’s symptoms, underlying health, and response to initial therapies.

Prognosis

With prompt and appropriate treatment, many patients experience full recovery. However, some may have recurrent or chronic disease requiring long-term management. Regular follow-up is crucial to monitor for relapses and manage any complications.

Orbital Inflammatory Disease can be a distressing condition, but with early diagnosis and expert care, the outlook is often good. If you experience sudden eye pain, swelling, or visual changes, don’t delay seeking medical attention.

For more information or to book a consultation, please contact my clinic directly. Early intervention remains the best defence against long-term complications.