Introduction: Orbital metastases are rare and they are even rarer to be the first sign of the disease, which can lead to misdiagnosis and delay of management.
Observation: Our patient consulted for a diplopia and a ptosis of the upper eyelid of the right eye since one month, without any other systemic symptoms. After ophthalmological examination and orbital tomography, the diagnosis of orbital metastasis was suspected. Lung cancer was revealed by thoracic tomography and confirmed by an anatomopahological examination.
Conclusion: Because of the increased incidence of neoplasia, the diagnosis of orbital metastasis should be considered in any elderly patient who consults for symptomatology related to orbital involvement.