Contributors: Mohammed Al Falah and Miguel Cruz Pimentel
Patient Presentation: A 44-year-old female was referred to a tertiary retina centre for vision loss in the left eye for 3 weeks. Her past ocular history was unremarkable. Her past medical history was significant for advanced breast cancer with known bone metastasis requiring chemotherapy. She denied pain or red eye, but she did note occasional flashes in the periphery over the last few days.
On examination, her best corrected visual acuity was 20/25 OD and 20/400 OS. Her IOP was 12 mmHg OD and 15 mmHg OS. The anterior segment examination was normal, with no signs of inflammation. Fundus examination of the right eye was within normal limits. Fundus examination of the left eye revealed a hyperemic optic nerve swelling as well as an elevated non-pigmented choroidal lesion inferior to the optic nerve. The lesion is at least 10 DD in size with an extension to the macula and subfoveal area.