Clinical Review & Education JAMA Ophthalmology Clinical Challenge Peter J. Belin, BA; Ajay E. Kuriyan, MD, MSc; Chrisfouad R. Alabiad, MD Figure 1. Clinical photograph at presentation demonstrating a large, hemorrhagic, necrotic mass obscuring the entire globe and eyelids of the left eye. A man in his late 30s presented to the emergency department for a left eye mass impairing his vision. He reported that he first noticed a small lesion on the nasal conjunc- WHAT WOULD YOU DO NEXT? tiva of his left eye 6 months earlier; there was rapid growth during the last 2 months. The mass became painful 4 weeks earlier and started to A. Exenteration affect his vision 2 weeks earlier. His ocular history Quiz at included enucleation of his right eye secondary to a jamaophthalmology.com B. Computed tomographic scan of traumatic ruptured globe 6 years previously. He the orbit denied any systemic medical problems and was not taking any medications. On examina- tion, his visual acuity was no light perception OD (prosthesis) and light perception OS. C. Enucleation External examination revealed a well-fitting prosthesis in the right eye with a healthy upper and lower eyelid fornix. The left eye is shown in Figure 1.
JAMA Ophthalmology – American Medical Association
Published: Apr 1, 2015