A high index of suspicion and appropriate intervention with histological diagnosis can help in the management and quality of life in patients with metastatic orbital disease. Overall survival is limited and we encountered statistical limitations proving differences in the survival based on the sub-type of primary tumour involved. Metastatic orbital melanoma presented a higher incidence when compared with previous studies, probably due to the increase frequency of skin found in the Australian population.

Apocrine adenocarcinoma is a rare adnexal tumor of the eyelid, which may present with orbital invasion.

The silent sinus syndrome is a cause of spontaneous enophthalmos associated with unilateral chronic maxillary atelectasis. It remains an under-recognised condition in both the ophthalmological and otolaryngological community. We present a case of a 46-year-old lady with a six-month history of enophthalmos to illustrate the clinical features and radiological findings of this condition. Four years prior to presentation, she had normal maxillary sinuses on magnetic resonance imaging.

Cholesterol granuloma is an uncommon entity, occurring typically in the supero-temporal orbit. Recurrence has only rarely been reported. We describe a case of recurrent cholesterol granuloma in a 48-year-old-man to illustrate the clinical features of the condition, and to highlight the importance of complete resection to prevent recurrence.

Mohs' micrographic surgery (MMS) is an effective means of margin control in the management of periocular basal cell carcinomas (BCC). We describe three cases of recurrent BCC that presented with progressive eyelid contracture after MMS. They illustrate high-risk factors for recurrence, namely large tumor size, medial canthal location, previous treatment, and aggressive histological features. Careful long-term surveillance with serial photography may identify early eyelid contracture and thus assist in the detection of recurrent BCC after MMS and improve patient outcome.