A patient with an ocular history of OSSN presents with several months of monocular double vision in his right eye. He states that symptoms came on slowly and have progressively gotten worse. His exam was notable for a vision of 20/150 in the right eye that pin-holed to 20/50 and a vision of 20/40 in the left eye. Intraocular pressures were within normal limits. Slit lamp exam was most notable for a Raised, vascularized conjunctival lesion superiorly that continued onto the superior 30% of the cornea. The lesion was clinically very suspicious for ocular surface squamous neoplasm and was subsequently imaged with an anterior segment OCT which revealed epithelial thickening and hyperreflectivity as well as a sub-epithelial lesion with no clear normal-dysplastic transition zone. These findings were not consistent with a typical OSSN, and a biopsy was taken which had findings consistent with squamous cell carcinoma. He has now started treatment with topical chemotherapy, 5-fluorouracil and will be followed up with repeat anterior segment optic coherence tomography when four cycles of treatment have been completed.
Presentation Date: 10/05/2023
Issue Date: 10/20/2023