Progressive Vision Loss From Uveal Melanoma with Extraocular Extension: A Case Report

Area of Science:

• Ophthalmology
• Oncology

Background:

• Uveal melanoma is the most common primary intraocular malignancy in adults.
• Often diagnosed late, particularly in resource-limited settings, leading to limited therapeutic options.
• Diagnosis involves clinical examination, B-mode ultrasound, and histopathology.

Purpose of the Study:

• To report a case of uveal melanoma with delayed diagnosis.
• To highlight therapeutic limitations resulting from late presentation.
• To emphasize the need for early detection and improved referral systems.

Main Methods:

• Case report of a 67-year-old woman with progressive vision loss and ocular pain.
• Clinical examination, B-mode ultrasound, and histopathological confirmation (enucleation).
• Staging per American Joint Committee on Cancer criteria.

Main Results:

• A 67-year-old woman presented with a 3-year history of vision loss and pain.
• Examination revealed light perception vision, high intraocular pressure, and a large choroidal tumor.
• Enucleation confirmed a 19-mm-thick uveal melanoma with scleral invasion; no metastases were found on CT.

Conclusions:

• Delayed presentation necessitated enucleation as the sole treatment option.
• This case highlights the critical need for public awareness and early detection of pigmented ocular lesions.
• Effective referral systems are essential for timely specialized care and vision preservation.