Orbital lymphoma is a cancer of the immune system that grows in or around the eye. The “orbit” is the bony space that holds the eyeball, the muscles that move the eye, the optic nerve, the fat, the tear (lacrimal) gland, the eyelids, and the conjunctiva. A lymphoma is a cancer that comes from lymphocytes. Lymphocytes are white blood cells that help the body fight germs. When these cells become abnormal and multiply without control, they can form a tumor. When this tumor forms in the orbital tissues, it is called orbital lymphoma.

Orbital lymphoma is a cancer of the body’s infection-fighting B-cells that grows in or around the eye—most often in the eyelids, the conjunctiva (the pink inner lining, where a “salmon-colored” patch can appear), the lacrimal (tear) gland, or the soft tissues of the orbit. Most cases are a slow-growing type called extranodal marginal zone lymphoma (MALT lymphoma), but some are faster-growing types such as diffuse large B-cell lymphoma (DLBCL). Doctors confirm the diagnosis with a small surgery called a biopsy, where a piece of tissue is examined under the microscope with special stains and genetic tests. Imaging—usually MRI or CT of the orbits and sometimes PET/CT—helps show how far it has spread and guides treatment planning. Localized MALT lymphoma of the orbit is highly sensitive to radiotherapy, which often cures the disease in the eye; systemic therapy is used if disease is widespread or high-grade. PMC+1

Orbital lymphoma most often grows slowly. Doctors call this “low-grade” or “indolent.” It can also be faster in some people. Doctors call that “high-grade” or “aggressive.” Many people notice a firm, painless swelling in the eyelid or near the eye. Some people see the eye pushed forward. Some people have double vision. Some people have no pain at all. Orbital lymphoma can be primary (it starts in the orbit) or secondary (it spreads to the orbit from lymphoma somewhere else in the body).

This condition is treatable. Doctors use radiation, antibody-based medicines, and sometimes chemotherapy. Cure and control rates are often good, especially for slow-growing types. The key is correct diagnosis and careful staging (finding out how far it has spread). The rest of this guide explains the important details in easy language.

---

Main Types of Orbital Lymphoma

Doctors group orbital lymphoma by cell type, growth speed, and location. Here are the types you will most often hear about, explained in simple words:

1. Extranodal marginal zone B-cell lymphoma (MALT lymphoma)
   This is the most common type around the eye. “Extranodal” means it grows outside regular lymph nodes. “MALT” stands for mucosa-associated lymphoid tissue. It is usually slow growing. It often shows up in the conjunctiva or the tissues around the eye.

2. Diffuse large B-cell lymphoma (DLBCL)
   This type is faster growing. It is called “high-grade.” It needs quick treatment. It is less common in the orbit than MALT lymphoma.

3. Follicular lymphoma
   This is a slow-growing B-cell lymphoma. It can involve the orbit. It often behaves gently but can change over time.

4. Small lymphocytic lymphoma / Chronic lymphocytic leukemia (SLL/CLL)
   This is a slow B-cell disease that can involve the eyelids or orbit, often in older adults.

5. Lymphoplasmacytic lymphoma
   This is a rare slow type. Some people may have a protein in the blood called an M-protein. It can affect the orbit.

6. Mantle cell lymphoma
   This is less common in the orbit. It can be more aggressive than MALT or follicular types.

7. T-cell lymphomas and NK/T-cell lymphomas (rare in the orbit)
   These are uncommon around the eye. When present, they can behave aggressively and need fast, specialized care.

8. Hodgkin lymphoma (very rare in the orbit)
   This lymphoma mainly affects lymph nodes. Orbital involvement is unusual but possible.

9. By location
   Doctors also describe the lymphoma by where it grows: conjunctival (the clear pink tissue), eyelid, lacrimal gland (tear gland), intraorbital soft tissues (fat or muscle), or optic nerve sheath (around the nerve). The location helps guide imaging and biopsy planning.

10. By behavior
    Doctors may call the disease low-grade (slow) or high-grade (fast). This label helps choose the best treatment plan.

---

Causes

Lymphomas usually do not have a single direct cause like a single germ or a single injury. Instead, several risk factors can raise the chance. Below are 20 factors that research has linked to orbital or ocular adnexal lymphoma. Each item is described in simple terms. Not every person with these factors will get lymphoma. Many people with orbital lymphoma have none of these known risks.

1. Older age
   Most patients are middle-aged or older. The risk rises as we age because cells collect more genetic mistakes over time.

2. Male sex (slight predominance)
   Some studies show men may be affected a little more often than women.

3. Chronic inflammation in or around the eye
   Long-lasting irritation may stimulate lymphoid tissue to grow. Over time, abnormal growth can appear.

4. Autoimmune diseases (like Sjögren’s syndrome or Hashimoto’s thyroiditis)
   Autoimmune conditions activate immune tissues for years. Constant stimulation can increase risk in tissues like the lacrimal gland.

5. Immune system weakness from medicines
   Medicines after organ transplant or for severe autoimmune disease can reduce immune surveillance and increase lymphoma risk.

6. Immune system weakness from illnesses
   Infections like HIV can impair the immune system and raise lymphoma risk in general.

7. Past radiation exposure
   Prior radiation to the head or face for other conditions can slightly increase risk over time.

8. Certain chronic infections
   Some regions report a link between ocular adnexal MALT lymphoma and Chlamydia psittaci infection. The strength of this link varies by country.

9. Hepatitis C virus
   Hepatitis C has been linked to some B-cell lymphomas. It may trigger chronic stimulation of B cells.

10. Family history of lymphoma
    Having a close relative with lymphoma may modestly increase personal risk.

11. Occupational exposures
    Long-term exposure to pesticides, solvents, or certain industrial chemicals has been associated with lymphoma risk in some studies.

12. Prior non-Hodgkin lymphoma elsewhere
    People with systemic lymphoma can later have spread to the orbit.

13. Chronic conjunctivitis or eyelid margin disease
    Ongoing surface inflammation may contribute to local lymphoid tissue growth.

14. Thyroid eye disease (autoimmune)
    Autoimmune eye swelling can coexist with lymphoid tissue changes around the eye in rare cases.

15. Cigarette smoke exposure
    Smoking affects immune and inflammatory pathways and may add to risk for some lymphomas.

16. Vitamin D deficiency (possible association)
    Low vitamin D has been studied as a general cancer risk factor. Evidence is mixed but suggests a possible role in immune regulation.

17. Genetic changes in B cells
    Certain chromosomal changes in B cells can drive lymphoma formation, such as changes in genes that control cell growth.

18. Environmental dusts and allergens
    Long-term exposure may keep the local immune system activated. This is a minor and non-specific factor.

19. Prior eyelid or conjunctival tumors or surgery
    Most surgeries do not cause lymphoma. But scarred, chronically inflamed tissues can sometimes host lymphoid growth.

20. Obesity and metabolic inflammation (general cancer risk)
    Chronic low-grade inflammation in obesity may influence immune cells over many years.

---

Common Symptoms and Signs

Symptoms vary by tumor size, location, and speed of growth. Some people have very subtle changes. Some have a visible mass. Pain is often mild or absent, especially with slow-growing types. Here are 15 common symptoms and signs, explained simply:

1. Painless eyelid swelling
   The lid looks puffy or thicker. It may feel firm when touched.

2. A visible “salmon-pink” patch on the conjunctiva
   This is a classic sign in some people. It looks like a pink, flat, smooth area on the white of the eye.

3. A firm mass in the eyelid or near the eye
   You may feel a rubbery lump in the lid or corner of the eye.

4. Eye bulging (proptosis)
   The eye may look pushed forward. This happens when a mass occupies space in the orbit.

5. Double vision (diplopia)
   The eyes may not move together normally if a mass restricts an eye muscle.

6. Limited eye movement
   Looking to one side may feel tight or painful if a muscle is involved.

7. Droopy eyelid (ptosis)
   The upper lid may sit lower if the mass affects the lid or its muscles.

8. Eye pressure or fullness
   People may feel a pushing or heavy sensation behind or around the eye.

9. Redness or irritation
   The conjunctiva may look red because tissues are congested or dry.

10. Excess tearing (epiphora) or dry eye symptoms
    The lacrimal gland can be involved, which can change tear flow.

11. Decreased or blurry vision
    Vision may drop if the optic nerve is compressed or if the surface of the eye gets dry or irregular.

12. Visual field changes
    Some people notice blind spots or edges of the field missing if the optic nerve is pressed.

13. Pain (often mild or absent)
    Pain is not common with slow types. Faster types or infections can cause discomfort.

14. A feeling of a foreign body in the eye
    The “salmon patch” or surface swelling can feel like grit or a film over the eye.

15. Systemic “B” symptoms (less common)
    Unexplained weight loss, night sweats, or fevers can occur if disease is widespread, but they are not typical in isolated orbital disease.

---

Diagnostic Tests

Diagnosis requires a careful exam, imaging, and most importantly a biopsy. A biopsy means taking a small piece of the mass to look at under the microscope. Pathology confirms the exact type. Staging tests then look for disease elsewhere. Below are 20 tests, grouped into five practical categories, with simple explanations of what each test does and why it matters.

A) Physical Exam

1. Detailed eye and orbital inspection and palpation
   The doctor looks closely at the eyelids, conjunctiva, and eye position. The doctor gently presses the lids and orbit to feel the size, firmness, and mobility of any mass. This first step guides which imaging and biopsy route is safest.

2. Regional lymph node examination
   The doctor feels the lymph nodes in front of the ear, under the jaw, and in the neck. Enlarged nodes can suggest spread beyond the orbit.

3. Cranial nerve and neurologic screening
   The doctor checks facial sensation, eye movements, eyelid strength, and vision-related nerve functions. This helps detect nerve compression or spread.

4. General systemic examination with B-symptom review
   The doctor checks weight changes, night sweats, fever, and any swelling elsewhere. This helps decide how broad the staging work-up should be.

B) Manual / Bedside Tests

5. Visual acuity testing
   You read letters on a chart. This test measures how clearly you see. It provides a baseline to watch for change during and after treatment.

6. Pupillary exam for a relative afferent pupillary defect (RAPD)
   The doctor shines a light to see how pupils react. An RAPD suggests stress on the optic nerve or retina from pressure or infiltration.

7. Ocular motility testing (ductions and versions)
   You follow a target in different directions. The doctor notes any restrictions, pain, or double vision. This shows if a mass involves an eye muscle.

8. Exophthalmometry (Hertel measurement)
   A simple device measures how far forward each eye sits. This documents eye bulging and helps track response to therapy.

9. Confrontation visual field testing
   You cover one eye while the doctor checks whether you can see finger movements in your side vision. This screens for optic nerve or pathway compression.

C) Lab & Pathology

10. Complete blood count (CBC) with differential
    This blood test checks red cells, white cells, and platelets. Some lymphomas alter white counts or cause anemia. A normal CBC does not exclude orbital lymphoma, but it is an important baseline.

11. Serum LDH and beta-2 microglobulin
    These blood markers can reflect tumor activity in some lymphomas. They help with staging and prognosis, especially in faster types.

12. Hepatitis C and HIV serology
    These infections can affect immune function and influence lymphoma risks and treatment choices. Knowing status helps shape safe care.

13. Tissue biopsy with histopathology and immunohistochemistry (IHC)
    This is the gold standard for diagnosis. A small piece of the mass is removed. A pathologist looks at the cells and uses special stains (IHC) to find proteins that define the lymphoma type, such as B-cell markers (like CD20). The pathologist also checks how aggressive the cells look.

14. Flow cytometry on tissue
    This lab method studies thousands of cells quickly to determine their “immunophenotype” (what markers they carry). It helps confirm if the cells are clonal B cells or another lineage.

15. Molecular genetics: IGH clonality and FISH panels
    Genetic tests look for repeated patterns that show a single clone of B cells (clonality). FISH can look for changes in genes linked to lymphoma behavior. In suspected lymphoplasmacytic disease, a MYD88 mutation may be checked. These tests refine the exact diagnosis.

16. Chlamydia psittaci testing (PCR on tissue or swab when appropriate)
    In some regions, this bacterium has been linked to ocular adnexal MALT lymphoma. Testing can be considered based on local practice and clinical judgment.

D) Electrodiagnostic

17. Visual evoked potentials (VEP)
    This test measures the brain’s response to visual signals. If the optic nerve is compressed or damaged, the signal may be delayed or reduced.

18. Electroretinography (ERG)
    This test measures the retina’s electrical response to light. ERG is usually normal in pure orbital disease, but it helps if there is suspected retinal or choroidal involvement.

E) Imaging

19. Orbital MRI with contrast (often with diffusion-weighted imaging)
    MRI shows soft tissues in great detail. It helps define the size, shape, and exact location of the mass. It shows whether the mass is in the lacrimal gland, muscle, fat, or near the optic nerve. MRI helps the surgeon plan the safest biopsy route.

20. Whole-body PET-CT for staging (or CT chest/abdomen/pelvis if PET is not available)
    PET-CT checks whether lymphoma is present anywhere else in the body. This matters because treatment can change if disease is widespread. If PET-CT is not possible, CT scans of the chest, abdomen, and pelvis help with staging.

Non-pharmacological treatments (therapies & “other” care)

1) Curative orbital radiotherapy (RT).
Small, precise X-ray beams treat the orbit or conjunctiva. For indolent MALT, 20–25 Gy in 10–15 sessions is highly effective with careful lens shielding to reduce cataracts. Many centers use 24 Gy as a standard. Side effects include dry eye and cataract, typically emerging months to years later. PMC+1ScienceDirect

2) Ultra-low-dose RT (2 Gy × 2 = 4 Gy), response-adapted.
In selected early MALT cases, 4 Gy can induce complete responses with very low toxicity; if residual disease remains, centers may escalate later. This approach reduces side effects and treatment time but may have a slightly higher local relapse risk in some settings. PMC+1The Lancet

3) Intensity-modulated radiotherapy (IMRT/VMAT).
Modern planning bends the dose around healthy tissues (lens, macula, lacrimal gland) to protect vision while maintaining tumor dose. Annals of Lymphoma

4) Proton therapy (selected centers).
Protons can spare tissues beyond the target; used rarely for orbital lymphoma but considered in complex anatomy. (Evidence extrapolated from head/neck and ocular series.)

5) Observation (“watch-and-wait”) for very indolent, asymptomatic disease.
Some marginal zone lymphomas grow so slowly that short, supervised observation is reasonable until treatment is clearly needed.

6) Biopsy (diagnostic minor surgery).
Essential to confirm the exact lymphoma type; treatment depends on this. Usually incisional rather than full removal.

7) Eyelid hygiene and warm compresses.
Improves lid margin health if blepharitis is present and eases irritation.

8) Lubrication: preservative-free artificial tears/gel/ointment.
Relieves dryness from the tumor or post-RT surface changes.

9) Moisture chamber goggles or humidifiers.
Reduce evaporation to protect the ocular surface after RT dryness.

10) Punctal plugs (tiny tear-drain stoppers).
A quick office procedure that keeps tears on the eye longer; helpful for moderate–severe dry eye after RT.

11) Scleral contact lenses.
Vault over the cornea with a liquid reservoir, soothing severe surface dryness or exposure.

12) Low-vision rehabilitation aids.
Magnifiers, contrast tools, and task lighting help if vision is affected.

13) Cataract counseling and timing.
Radiation-related cataract can occur; cataract surgery usually restores clarity when needed.

14) Glaucoma monitoring.
Tumor mass effect, steroid use, or angle changes can raise eye pressure; regular checks matter.

15) Psychosocial and survivorship support.
Anxiety is common; counseling and peer groups help coping and adherence.

16) Exercise plan (as tolerated).
Light activity reduces fatigue and improves quality of life during therapy.

17) Safe food handling when immune-suppressed.
If you receive systemic therapy, follow CDC food-safety steps (clean, separate, cook, chill) to lower infection risk. Strict “neutropenic diets” are often unnecessary; safe handling is the key.

18) Vaccination updates (non-live vaccines).
Your oncology team may recommend inactivated vaccines on a safe schedule; live vaccines are generally avoided during significant immunosuppression.

19) Eye protection at work/home.
Avoid trauma to a radiated, dry ocular surface.

20) Coordinated care with hematology–oncology and radiation oncology.
Best outcomes come from a team following lymphoma guidelines.

---

Drug treatments

Doses below are typical examples for adults; your team individualizes them to your size, kidney/liver function, and exact subtype. Do not self-medicate.

1. Rituximab (anti-CD20 monoclonal antibody).
   Class: anti-CD20. Typical dose: 375 mg/m² IV weekly ×4 or on day 1 of each chemo cycle; subcutaneous formulations exist after one IV dose. Purpose: cornerstone for B-cell lymphomas, often combined with chemo. Mechanism: flags CD20-positive B-cells for immune removal. Key risks: infusion reactions, hepatitis B reactivation → universal HBV screening and monitoring required.

2. Bendamustine + Rituximab (BR).
   Class: alkylator + anti-CD20. Typical dose: bendamustine 90 mg/m² IV days 1–2 q28d + rituximab 375 mg/m² day 1. Purpose: highly active for marginal zone lymphomas needing systemic therapy. Mechanism: DNA cross-linking plus anti-CD20. Side effects: low blood counts, infection risk.

3. R-CVP (rituximab, cyclophosphamide, vincristine, prednisone).
   Class: chemo-immunotherapy without anthracycline. Use: indolent disease needing systemic therapy. Mechanisms: DNA damage, microtubule inhibition, immune targeting. Risks: neuropathy (vincristine), cytopenias, infections.

4. R-CHOP (adds doxorubicin).
   Class: anthracycline-based chemo-immunotherapy. Use: aggressive histology (e.g., DLBCL) or transformation. Risks: low counts, cardiotoxicity (doxorubicin), infections; requires growth-factor support in some.

5. Chlorambucil ± Rituximab.
   Class: oral alkylator. Use: very indolent disease in frail patients. Risks: cytopenias, nausea.

6. Lenalidomide + Rituximab (“R²”).
   Class: immunomodulatory + anti-CD20. Typical dose: lenalidomide 20 mg PO days 1–21 q28d with rituximab per protocol. Use: relapsed or selected patients. Risks: cytopenias, rash, thrombosis (needs prophylaxis).

7. Zanubrutinib (BTK inhibitor).
   Class: targeted oral therapy. Typical dose: 160 mg twice daily. Use: relapsed/refractory marginal zone lymphoma; FDA-approved. Risks: bleeding, atrial fibrillation (lower rates vs older BTKis in some data), infections, cytopenias. PMC

8. Ibrutinib (BTK inhibitor).
   Class: targeted oral therapy. Typical dose historically: 560 mg daily. Use: R/R MZL in some regions; note: U.S. MZL indication was withdrawn in 2023, though data exist and use varies by country. Risks: bleeding, AF, infections, diarrhea. Regulatory status differs by region. PMC

9. Interferon-α (intralesional or systemic; historical/selected use).
   Class: immunotherapy. Use: uncommon now, but used in select small lesions or when other options unsuitable. Risks: flu-like symptoms, mood changes. PMC

10. Doxycycline (antibiotic) for C. psittaci–associated OAML (selected regions).
    Typical dose: 100 mg twice daily for 3–6 weeks, sometimes longer. Purpose: in areas with a proven link, eradicating the bacterium can shrink the lymphoma; results vary by geography; not a universal standard. Risks: photosensitivity, GI upset; only used when appropriate testing/epidemiology supports it. PubMedPMC

---

Dietary “molecular” supplements

Important: Supplements do not treat lymphoma. Discuss each with your oncology team, because some interact with chemo or increase bleeding risk.

1. Vitamin D — 1,000–2,000 IU/day typical; UL 4,000 IU/day. Supports bone/immune health; check a blood level and avoid excess.

2. Omega-3 (EPA/DHA) — commonly 1 g/day; may help triglycerides and inflammation; high doses can raise bleeding risk.

3. Curcumin (turmeric extract) — 500–1,000 mg/day; anti-inflammatory/antioxidant; watch drug interactions; evidence in cancer is exploratory.

4. Green tea extract (EGCG) — 250–400 mg/day; antioxidant; may interact with some drugs and can affect liver enzymes—use caution.

5. Selenium — 100–200 mcg/day (UL 400 mcg); antioxidant enzyme cofactor; avoid excess.

6. Probiotics — strains/doses vary (e.g., ≥10⁹ CFU/day); may reduce antibiotic-associated diarrhea, but use caution in immunocompromised patients; discuss with your team.

7. Melatonin — 3–10 mg at bedtime; helps sleep during treatment; can interact with some sedatives.

8. Ginger — 1–2 g/day; may ease nausea.

9. L-glutamine — 10 g, 2–3×/day sometimes used for mucositis/diarrhea; evidence mixed—ask your team.

10. Whey protein (20–40 g/day) — helps maintain protein intake if appetite is poor.

(For supplements without strong NIH/NCCIH pages above, your oncology dietitian can tailor advice; avoid megadoses of antioxidants during chemo/RT unless your oncologist approves.)

---

Regenerative/stem-cell–related drugs

These are supportive medicines your team may use to protect blood counts or mobilize stem cells if you ever need transplant—not treatments for the eye tumor itself.

1. Filgrastim (G-CSF): ~5 mcg/kg/day SC to raise neutrophils after chemo; mechanism: stimulates marrow neutrophil production; risks: bone pain, rare spleen issues. PMC

2. Pegfilgrastim: single 6 mg SC after chemo cycle; long-acting G-CSF. PMC

3. Sargramostim (GM-CSF): ~250 mcg/m²/day; boosts neutrophils/monocytes. PMC

4. Epoetin alfa (EPO): 40,000 U weekly for chemo-induced anemia (selected cases); mechanism: stimulates RBC production; risks: clotting, hypertension—used under strict rules. PMC

5. Romiplostim or Eltrombopag (TPO agonists): weekly SC (romiplostim) or daily PO (eltrombopag) to raise platelets in chronic thrombocytopenia; used selectively. PMC

6. Plerixafor: 0.24 mg/kg SC for stem-cell mobilization with G-CSF before autologous transplant in aggressive/relapsed cases. PMC

---

Surgeries and procedures

1. Incisional or excisional biopsy (orbitotomy or conjunctival biopsy).
   Why: the gold standard to diagnose the exact lymphoma type—treatment depends on this.

2. Debulking orbitotomy (rare).
   Why: occasionally done for diagnosis or to relieve tight mass effect; not curative for lymphoma.

3. Lacrimal gland–focused biopsy/resection (selected cases).
   Why: when imaging shows a lacrimal mass and tissue is needed for diagnosis.

4. Punctal plug insertion (office procedure).
   Why: treats significant post-RT dry eye by conserving tears.

5. Cataract surgery (when vision is limited).
   Why: radiation-related or age-related lens clouding; surgery usually restores clarity.

---

Prevention ideas

There is no proven way to prevent orbital lymphoma. These steps lower general risks and protect eye health during/after treatment:

1. Treat chronic eyelid/conjunctival inflammation early (good lid hygiene).

2. Hand hygiene and infection control—especially during chemo/rituximab.

3. Vaccinations as advised (non-live), timed around therapy.

4. Safe food handling to avoid food-borne infections when counts are low.

5. Avoid unnecessary immunosuppression (coordinate with other doctors).

6. Protect the eye surface (lubricate; shield in dusty/windy settings).

7. Manage autoimmune diseases with your specialists.

8. Discuss bird exposure if you keep birds in a region where C. psittaci is prevalent; seek care for chronic conjunctivitis. PubMed

9. Don’t smoke; limit alcohol, for overall cancer health.

10. Regular follow-up so small recurrences are caught early.

---

When to see a doctor—right away

• A new painless eyelid or conjunctival mass or a salmon-colored patch that persists.

• Sudden vision loss, double vision, or eye movement pain.

• New eye bulging or a rapid change in eye position.

• Fevers, night sweats, or weight loss.

• Worsening dryness, pain, or redness after radiotherapy or during systemic therapy.

---

Practical food tips

What to eat (examples):

1. Fully cooked proteins (chicken, fish, eggs) for strength.

2. Well-washed fruits/vegetables (or cooked) for vitamins and fiber.

3. Pasteurized dairy/yogurt (if your team approves probiotics, choose pasteurized).

4. Whole-grain breads and cereals for energy.

5. Plenty of fluids (water, soups) to stay hydrated.

What to avoid (especially when counts are low):

1. Raw or undercooked meats/eggs/seafood (e.g., sushi, runny eggs).
2. Unpasteurized milk, juices, or soft cheeses.
3. Raw sprouts and unwashed produce.
4. Deli meats unless steaming hot; avoid salad bars/buffets where handling is uncertain.
5. High-dose alcohol (dehydrates and stresses the body).

---

Frequently Asked Questions

1) Is orbital lymphoma “eye cancer” or “blood cancer”?
Both in a sense. It is a lymphoma (a blood/immune-cell cancer) growing in the eye’s surrounding tissues.

2) Is it contagious?
No. It is not an infection, though certain bacteria (like C. psittaci) are linked in some regions.

3) Can it be cured?
Localized MALT lymphoma in the orbit often has excellent control and functional outcomes with radiotherapy. Aggressive types need systemic therapy; many are curable or very controllable. PMC

4) Will I lose my eye or my vision?
That is uncommon with modern care. The goal is to preserve the eye and vision. Cataract can develop after RT but is fixable with surgery in most cases.

5) Why not just remove the lump surgically and be done?
Lymphoma cells are microscopic and may extend beyond what is visible. Biopsy gives the diagnosis; radiotherapy or systemic therapy treats the disease effectively.

6) What dose of radiation is typical?
Many centers use ~24 Gy (about 12 sessions). Some use ultra-low-dose 4 Gy in selected early MALT with response-adapted plans. Your radiation oncologist balances control and side-effects. PMC+1

7) What side-effects should I expect after orbital RT?
Temporary irritation or dryness, and over time cataract risk rises; retinopathy is uncommon with modern lens-sparing plans. Lubrication and follow-up help. PMC

8) Do I need chemotherapy?
Not if you have a small, localized MALT confined to the orbit—RT alone is often curative. You may need systemic therapy for aggressive histology or widespread disease. PMC

9) What about antibiotics (doxycycline)?
Only sometimes helpful—in regions where C. psittaci truly drives the lymphoma. It’s not a global standard; your team decides based on testing and local data. PubMed

10) Are BTK inhibitors like zanubrutinib an option?
Yes, zanubrutinib is an option for relapsed marginal zone lymphoma; ibrutinib’s U.S. MZL indication was withdrawn in 2023 but may be used elsewhere. These drugs are for systemic disease, not as primary eye-only therapy. PMC+1

11) Can diet or supplements cure it?
No. Diet supports your strength and recovery; it doesn’t replace radiotherapy or lymphoma-directed treatment.

12) Will I need a bone marrow biopsy or PET/CT?
Sometimes, based on subtype/stage. PET/CT helps confirm localized disease or detect aggressive transformation; FDG uptake in MALT can be variable.

13) Can both eyes be affected?
Yes; bilateral disease occurs, so both eyes are evaluated.

14) How often is follow-up?
Typically every 3–6 months initially, then yearly, with eye exams and systemic checks individualized to your subtype.

15) What should I tell other doctors?
Share that you have a B-cell lymphoma and whether you received anti-CD20 therapy (rituximab), because that affects HBV screening, vaccination timing, and infection precautions.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 19, 2025.

PDF Document For This Disease Conditions References