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Adenoid Cystic Carcinoma A patient with past medical history of a previously resected lacrimal gland mass presented to the emergency room with worsening unilateral proptosis and eye pain with persistent new eversion of the upper eyelid for several days. Examination was significant for severe propto…

Adenoid Cystic Carcinoma of the Lacrimal Gland A 43-year-old female presented to her primary care physician with swelling of the lateral aspect of the right upper eyelid without visual complaints. The primary care physician noted proptosis of the right globe and ordered a CT scan which revealed a m…

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…

Histopathology and radiographic images of rhabdomyosarcoma in a young infant.

Bilateral Retinoblastoma A 7-month-old girl with a white pupil in the right eye is diagnosed with group D retinoblastoma in the right eye and group B retinoblastoma in the left eye. Her right eye is treated with intra-arterial chemotherapy with melphalan, carboplatin, and topotecan. Her left eye wa…

Carcinoma Ex Pleomorphic Adenoma A 76-year-old female referred by primary care physician for right eye proptosis. The patient complained of diplopia for the last six months without associated pain or irritation. External exam was significant for proptosis of the right eye and hypoglobus. Visual acu…

Choroidal Metastasis Consistent with Renal Cell Primary A 57-year-old male presented to clinic with a one-week history of red line in his vision OS. The patient was noted to have a history of left nephrectomy for renal cell carcinoma that was diagnosed after a metastatic lesion was detected in the …

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

Slit lamp photo with white tumor growing into the sulcus inferior temporally. The Ultrasound Biomicroscopy shows a medium density mass in the ciliary body. The patient had known stage 4 lung cancer.

Circumscribed Choroidal Hemangioma A patient presented with blurry vision OD. VA 20/40 OD and 20/20 OS. DFE significant for elevation along the superior arcade. Imaging workup significant for OCT showing foveal involving serous retinal detachment OD. FA and ICG showed hyperfluoroescent lesion super…

Conjunctival Melanoma A 38-year-old healthy man presents with a pigmented lesion two years after onset and undergoes excisional biopsy which confirms conjunctival melanoma. Systemic work-up reveals metastasis, and the patient undergoes multiple cycles of radiation and chemotherapy. He later died of…

A large pigmented nasal growth with vascularization. This case was treated with surgery using a 'no touch technique' excisional biopsy with 4 mm margins and amniotic membrane tissue placement.

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…

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…

Extranodal Marginal Zone Lymphoma 52-year-old male with Stage IV extranodal MALT lymphoma who initially presented with paranasal and perioribtal disease. He failed treatment with multiple chemotherapeutic agents and represented with decreased VA 20/40 and 20/80 thought to be due to diffuse choroida…

Exudative Retinal Detachment Following Treatment of Posterior Uveal Melanoma A 55-year-old male presented to Bascom Palmer with complaints of flashing lights in his right eye and found to have a large choroidal mass. Work-up revealed a likely choroidal melanoma with an associated small inferior exu…

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…

The patient presented with an enlarging lower eyelid lesion for 2 months. There was irregular pigmentation without ulceration or madarosis. Biopsy confirmed an intradermal nevus.

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. …

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…