This is a review of 241 patients diagnosed with periocular sebaceous gland carcinoma which investigates whether age at presentation influences either the clinical presentation or the outcomes of treatment. Twelve percent of patients were classified as young (<40 years old), 51% were middle-aged (41-60) and 37% were older (>60). There were no differences in the clinical presentation or the treatment modalities between the age groups, with 79% managed by wide excision. Orbital exenteration was primary treatment in 11% and systemic chemotherapy in 10%. The only histopathological difference between the age groups was that Pagetoid spread was more common amongst the middle-aged. Perivascular and perineural invasion were relatively rare with overall rates of 7% and 4% respectively. In terms of outcomes, local tumour recurrence was more common in the older age group, and there was a trend towards higher regional and distant spread, and death in the young. However, these results may have been affected by other factors such as more conservative approaches or immune senescence in older patients. The study suffers from a lack of long-term follow-up data and the authors recognise that the study population from India may be fundamentally different to Caucasians, with Indians and Chinese having a higher disease prevalence occurring at a younger age. In India, sebaceous cell carcinoma is twice as common as basal cell carcinoma.