Objective: To determine whether current telemedicine technology can support real-time surgical telementoring to remove an orbital tumor, Design: Interventional case report Methods: An orbital specialist guided a general ophthalmologist in the removal of a lateral orbital tumor from a Site 210 miles away on another island. A 3-mm endoscope connected to a three-chip digital video camera attached to a Concorde 4500 Picture-Tel videoconferencing system was used to transmit images at a rate of 384 kb per second over integrated service digital network lines. Main Outcome Measures: Successful performance and outcome of the telementored procedure comparable to hands-on orbital surgery. Results: The surgical procedure was successfully telementored with uncomplicated removal of the orbital tumor. Conclusions: Current telemedicine technology can support real-time telementoring to remove an orbital tumor. Ophthalmology 2000;107:1468-1471 (C) 2000 by the American Academy of Ophthalmology.