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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…

Large sub-ILM hemorrhage leading to sub-retinal exudative changes in a patient with leukemia.

Squamous Cell Carcinoma, Metastatic Prostatic Adenocarcinoma A 77-year-old Caucasian male with a history of locally advanced prostate cancer on androgen deprivation therapy presented to BPEI for evaluation of a right lower lid lesion present for six weeks that did not improve with conservative trea…

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…

Group E retinoblastoma

Retinoblastoma A 2-year-old female with an unremarkable past medical history presented with pain and swelling of the left eye. One examination she was able to fix and follow with both eyes but had a dull red reflex of the left eye as well as a retinal mass. An exam under anesthesia was performed wh…

Pseudoangiomatous Retinal Gliosis A 54-year-old Hispanic male presented with decreased vision in the right eye over 3 months. Dilated fundus exam of the right eye showed a geographic area of chorioretinal alteration in the far temporal periphery at 9 o’clock, a gliovascular retinal mass superiorl…

Primary Uveal Melanoma, Left Eye A 30-year-old Hispanic female with a history of thyroid disease presented to the Bascom Palmer ER with complaints of blurry vision and eye strain in the left eye while reading for a 1-month duration. Her last eye exam was a decade ago and was normal. She was diagnos…

PAM and OSSN This case presents a 67-year-old gentleman who was referred for a pigmented lesion. The HR-OCT suggested that this was not simply a small area of PAM, but rather demonstrated an epithelial hyper-reflectivity and thickening with an abrupt change from normal to mildly thickened epitheliu…

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 …

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…

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…

In this module, we will look at:




Orbital Oncology


Conjunctival Oncology


Retinal Oncology


Uveal Oncology

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…

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. …

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.

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…

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…

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…

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…