Abstract: Orbital tumors encompass a diverse array of neoplasms arising from various tissues within the orbit, including the lacrimal glands and neural structures. This comprehensive review explores the classification, clinical features, diagnostic modalities, management strategies, and recent advancements in the treatment of lacrimal and neural orbital tumors. By elucidating the intricacies of these conditions, ophthalmologists can enhance their diagnostic acumen and optimize patient care.

Introduction: Orbital tumors present a diagnostic and therapeutic challenge due to their diverse histological subtypes and potential for causing visual impairment and orbital dysfunction. Understanding the distinct characteristics of lacrimal and neural tumors is paramount for accurate diagnosis and tailored management.

Lacrimal Tumors: Lacrimal tumors originate from the lacrimal gland or its ductal system and can manifest as benign or malignant lesions. Common lacrimal gland tumors include pleomorphic adenoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma. Clinical features may include proptosis, palpable mass, and epiphora. Imaging modalities such as MRI with contrast enhancement are essential for delineating tumor extent and guiding surgical planning. Recent innovations in lacrimal tumor management include the use of minimally invasive surgical techniques such as endoscopic transnasal dacryocystorhinostomy (DCR) and lacrimal gland-sparing surgical approaches, which aim to preserve ocular surface function and minimize postoperative morbidity.

Neural Tumors: Neural tumors in the orbit arise from structures such as the optic nerve, optic nerve sheath, or extraocular muscles. Common examples include optic nerve glioma, meningioma, and schwannoma. Clinical manifestations may include visual disturbances, optic disc swelling, and optic nerve dysfunction. Diagnosis often involves a combination of clinical evaluation, neuroimaging (MRI or CT), and occasionally histopathological analysis via biopsy. Recent advancements in the management of neural orbital tumors include the development of targeted molecular therapies and advanced radiotherapy techniques such as stereotactic radiosurgery, which offer precise tumor targeting and reduced radiation exposure to surrounding structures.

Conclusion: Lacrimal and neural orbital tumors represent a heterogeneous group of lesions with variable clinical presentations and management considerations. By integrating the latest diagnostic and therapeutic approaches, ophthalmologists can effectively navigate the complexities of these conditions and provide optimal care for their patients.

For further reading and reference:

• American Academy of Ophthalmology (AAO) – Orbital Tumors: https://www.aao.org/eye-health/diseases/orbital-tumors-list
• American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) – Orbital Tumor Management Guidelines: https://asoprs.org/assets/pdf/publications/ASOPRS-Orbital-Tumor-Mngmt-Guidelines-2019.pdf