Dr.ANOOP SINGH

Dr. PADMAJA KRISHNAN

Abstract

A 60 yr smoker male with LE redness and dull pain over left forehead of a month, BCVA LE-6/18 O/E showed nasal congestion, chemosis with dilated episcleral vessels, nasally shallow AC and on dilatation a solid mass behind the lens nasally extending upto obscured nasal disc, bullous inferior RD with macula off. USG B-scan and MRI confirmed intraocular mass involving nasal ciliary body and choroid. Acute presentation and radiological findings atypical of a melanoma suggestive of a metastasis whose primary was found in left lung. CT guided biopsy of lung lesion and hilar LN confirmed the diagnosis of squamous cell carcinoma. PET scan showed multiple metastasis and The patient was sent to the oncologist for further management. Melanoma is the commonest uveal malignancy but secondaries are close second. Carcinoma lung which affects smokers is known to metastasise to the eye. What made our patient unique is that he presented with ocular symptoms and signs while the primary remained silent.