The reported orbital mycetoma patients.

The reported patient is a middle-aged farmer from West Sudan who presented with a painless mass in the right upper eyelid that progressively enlarged over time. His medical treatment journey was prolonged and difficult. The mass was initially misdiagnosed as lacrimal gland pleomorphic adenoma. The patient was later referred to a specialised center, where wide local excision confirmed the diagnosis of Actinomadura madurae actinomycetoma. Although orbital mycetoma is uncommon, it is a serious condition that should be considered in the differential diagnosis in endemic areas.