A 65-year-old white male who notices occasional “flashes of light” is referred for a pigmented lesion of his left eye. He has an extensive cardiac history and smokes 30 packs of cigarettes a year. Visual acuity, intraocular pressure, pupils, and anterior segment exam are all normal for both eyes. Dilated fundus exam of the right eye is likewise normal; the left eye lesion is shown in these photos. A- and B-scan ultrasound of the lesion revealed a solid lesion measuring 20x17x8 mm with low internal reflectivity and no signs of extra-scleral extension.
Case contributed by: Daniel Neely, MD; Janine Collinge, MD; Maria Lim, MD