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Orbital Rhabdomyosarcoma - Recurrence A young patient with notable past ocular history of orbital rhabdomyosarcoma, s/p chemotherapy with vincristine, dactinomycin, and cyclophosphamide, and proton beam radiation presented to Bascom Palmer ED with 2 days of blurry vision and “seeing everything gr…

This patient presented with 1 month of left eyelid swelling. MRI showed infiltration in the periorbital soft tissues. Absolute CD4 count was 27 and the diagnosis was made with immunohistochemistry positive for HHV8. The patient was started on HAART therapy, the local lesions were treated with nitro…

Choroidal Metastases from Cutaneous Melanoma A patient with history of cutaneous melanoma presents with worsening vision of the right eye over a period of a few weeks. His exam was notable for visual acuity of 20/40 in the right eye and 20/25 in the left eye. Intraocular pressure was 18 in both eye…

Fundus photo of a patient showing a choroidal melanocytic lesion of the macula with subretinal fluid and orange pigment. The patient has a history of metastatic cutaneous melanoma.

Conjunctival Melanoma Two darkly pigmented patients with a diagnosis of conjunctival melanoma by an outside provider are presented here. Case 1 presented with a large jet black conjunctival lesion that was present for nearly 12 years. This lesion was biopsied by an outside provider and interpreted …

Metastatic Melanoma; Side Effect of Immune Checkpoint Inhibitor A patient with a history of recurrent metastatic conjunctival melanoma presented with a left upper lid orbital lesion and pigmented lesion in the medial fornix. The original conjunctival melanoma was originally excised in an outside ce…

Diffuse Iris Melanoma A patient presented for evaluation of multiple melanocytic lesions of the right iris that were noticed a few months prior. She was found to have a visual acuity of 20/25 in the right eye and 20/20 in the left eye, with intraocular pressures of 19mmHg in both eyes. Slit lamp ex…

Orbital Sarcoidosis A patient presented with three months of left eye swelling and pain. He was found to have periorbital firmness and fullness, proptosis, and conjunctival chemosis. He underwent computed tomography imaging of the orbits with contrast, which demonstrated an ill-defined, irregular a…

Melanocytoma with Vitreous Seeding A patient with 7 years of blurry vision in the right eye presents to clinic for evaluation. He reports no recent acute changes in vision and no precipitating events in the past. He noticed the blurry vision incidentally while driving when he covered his left eye. …

Enophthalmos Due to Metastatic Orbital Breast Carcinoma A patient presented to the ER with subconjunctival hemorrhage but incidentally noted to have enophthalmos with mild extraocular movement restriction in the contralateral eye. Further history revealed breast cancer history that was treated 18 y…

Sebaceous Carcinoma, Concern for Muir-Torre Syndrome Our patient presented with a greater than one year history of a non-resolving right eyelid mass that began to hemorrhage due to accidental trauma. Exam was remarkable for and extensive multi-lobar ulcerated mass found along the right lower lid al…

Granular Cell Tumor The patient presented to BPEI for evaluation of a two-week history of worsening diplopia. Examination revealed left unilateral proptosis. MRI orbit imaging revealed an intraorbital well-defined, well-circumscribed lesion arising at the level of the medial rectus. The patient und…

Orbital Metastatic Breast Cancer A patient presented to the ER with redness of the right eye for months. Initial exam revealed VA 20/50 and was noted to have right sided ptosis and ophthalmoplegia. MRI of the orbits was performed which showed an ill-defined right orbital mass. The patient underwent…

Histopathology and radiographic images of rhabdomyosarcoma in a young infant.

Alveolar Rhabdomyosarcoma A patient presented to BPEI for evaluation of a left upper lid lesion present since birth with no improvement with conservative treatment. Examination revealed a firm, blue, red lesion involving the upper left eyelid and lower eyelid. MRI orbit imaging revealed extensive s…

Uveal Effusion Syndrome A patient was referred to the ocular oncology service for evaluation of a suspicious choroidal mass and serous retinal detachment in the right eye. The Snellen visual acuity was 20/80 and intraocular pressures were normal in both eyes. Examination and imaging of the right ey…

Metastatic Cutaneous Melanoma to Choroid An elderly patient presented with vision loss in the right eye and self-referred to BPEI for a second opinion. A pigmented, elevated choroidal lesion concerning for malignancy was noted in the right eye with sub retinal fluid extending into the macula. The p…

Orbital Venous Lymphatic Malformation A patient presented to the ER complaining of 2 days of increasing pain and swelling behind the left eye. Of note the patient reported that as a teenager he was previously treated for an orbital tumor. On exam he was found to have massive proptosis, hyperglobus …

Chroroidal Osteoma is a rare benign tumor characterized by the presence of cancellous bone within the peripapillary choroid