A 2-year-old otherwise healthy boy presents with a lesion of the right eye that has rapidly enlarged over the past 4 days. There is associated photosensitivity but no pain, redness, swelling or discharge. The patient is able to fix and follow well in both eyes and appears orthophoric. Intraocular pressures are normal. The left eye is normal. Photos of the right eye are shown.

8 comments

  1. since its growing this fast I will consider inflammatory causes and I will also consider juvenile xanthogranuloma in my differential after performing a detailed ocular exam

    1. A rapidly enlarging mass, also consider lymphangioma, inflammatory condition like rupture dermoid you can consider, however both of this are not invoved in this case.

  2. Intesting case. See sorrounding skin lesion to exclude juvenile iris xanthogranuloma.leomyoma must be excluded.

  3. This lesion has a wide differential and all offered answers could be correct. RB should be considered and for that reason, imaging might have been reasonable. leukemia should be considered, and for that reason CDC might be reasonable. Careful skin examination is of course the most important thing. That would have been my first choice before any of the offered choices.

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