Objective: To evaluate the distribution and clinical as well as treatment outcome characteristics of idiopathic orbital inflammation with the aim of delineating a more systematic approach to diagnosis and treatment.Methods: A 10-year retrospective review of patients with idiopathic orbital inflammation treated at one institution.Results: Ninety eyes in 65 patients (22 men and 43 women) were studied. Diagnoses were isolated dacryoadenitis (n=21), isolated myositis (n=19), concurrent dacryoadenitis and myositis (n=5), orbital apex syndrome (n=6), and idiopathic inflammation involving the preseptal region, supraorbital region, sclera, Tenon capsule, orbital fat, or optic nerve (n=14). The mean age at presentation was 45 years. Pain and periorbital swelling were the most common clinical features and were observed in 45 (69%) and 49 (75%) patients, respectively. Seventeen patients (26%) had bilateral involvement. Biopsy was performed in 19 patients (29%) with atypical presentations or who failed to respond to the initial therapy. Patients were treated with steroids alone (n=45), steroids and subsequent radiation (REPRINTED) ARCH OPHTHALMOL / VOL 121, APR 2003 WWW.ARCHOPHTHALMOL.COM 491

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