Aim:  to study the prevalence, demographics, clinical and histolopathological features of orbital tumors biopsied in Hospital Serdang, a national Oculoplastic referral centre in Malaysia.

Methods: A retrospective, observational study on all the consecutive orbital biopsies performed in Hospital Serdang from January 2008 to December 2014.  Outcome measurement includes demographic data and histological diagnosis of biopsied orbital lesions. 

Results:  Among a total of 136 cases, there is slight male preponderence (59.6%). Malay is the commonest racial group (58.8%) followed by Chinese (32.4%).  Lymphoproliferative lesion is the most common category (34.6%) followed by inflammatory (10.3%) and lacrimal lesion (9.6%).  Benign lymphoid hyperplasia (16.9%) and Non Hodgkin lymphoma(BHL) (16.2%) were the most common histology diagnosis.  Those with benign lymphoid hyperplasia developed at a younger age (mean 56 years) compared to those with Non Hodgkin Lymphoma (60.6 years old).    Benign lymphoid hyperplasia occurred at a same frequency at orbit and lacrimal gland whilst those NHL were mostly located within the orbit.  Lymphoproliferative disorders are more common among male and Chinese.  Our patients develop cavernous haemangioma, pleomorphic adenoma and solitary fibrous tumor at an earlier age than Western counterparts.   Benign orbital lesions whilst being more common, may be associated with significant visual and orbital comorbidities.

Conclusions:  Lymphoproliferative lesions occur at a higher occurrence among Souteast Asian patients, especially among Chinese and male.   Our patients also develop cavernous haemangioma, pleomorphic adenoma and solitary fibrous tumor at an earlier age compared to their Western counterparts.  There is ethnic difference among different orbital pathologies.  Delayed presentation of benign orbital lesions lead to significant morbidity and sometimes exenteration.  Financial restraints may hinder clinicians in developing countries to obtain precise histological diagnosis.