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Photos courtesy of: LV Prasad Eye Institute Used with permission. Not to be reproduced.

A 24-year-old man presented with a history of the left eye getting smaller, but protruding forwards for the past one year. There was no history of trauma or surgical intervention in the past. On examination, best corrected visual acuity was 20/20 in the right eye and 20/40 in the left eye. On examination, the left eye was displaced in the infero-nasal direction and up gaze was restricted. There was mild ptosis and a non-tender mass was palpable in the supero-lateral quadrant, not extending beyond the superior orbital rim. Schirmer’s test was 30 mm in the right eye and 5 mm in the left eye. The anterior segment and fundus were within normal limits in the left eye. The right eye examination was unremarkable.

1.	What is the most probable diagnosis?
	a. pleomorphic adenoma b. adenoid cystic carcinoma c. non-specific orbital inflammatory disease (NSOID) d. neurofibromatosis
2.	The CT scan shows:
	a. indenting of the globe b. enlargement of lacrimal gland fossa c. none of the above d. both of the above
3.	The best treatment would be:
	a. incisional biopsy b. excisional biopsy c. excision + radiotherapy d. radiotherapy

For answers to the above, click here on or after January 20, 2009.