Case discussion: How would you treat this patient? [11 January]

This week we revisit a very interesting and unique case from Dr Slavko Doslo.

  • 63-year-old male
  • Lesion noted in the eye

What is your assessment of the clinical images? What would you do – if anything?

 

Update:

Here are the results. What next?

We encourage you to participate in the case discussions and submit your own clinical images and questions, so we can all learn together.

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12 comments on “Case discussion: How would you treat this patient? [11 January]

  1. The lesion has an excessive blood supply with markedly dilated and chaotic arbourising vessels.
    I would urgently refer to the best ophthalmologist I can find, with experience of the suspected diagnosis. (? Melanoma)

  2. Off white lesion arising from inside lower eyelid. Most notable feature is aborising blood vessels on magnification suggesting BCC.
    Would refer to opthalmologist for biopsy.

  3. The blood vessels pattern is suggesting a recent growth ( Loop)
    Considering the location and recent growth , IEC needs to get ruled out.
    Other DDx : Pterygium
    Management : Shave Biopsy to R/O IEC

  4. There are many branching torturous blood vessels on the sclera and its clearly crossing the cornea/ limbic….it sounds as Pterygium…would refer to ophthalmologist.

  5. I think, here, the expected issue is on/in the eye ball mainly because of its highlighted presentation in the bottom picture. Obviously Pterygium is a possibility because of its appearance, presence over nasal side of eyeball, & which is just crossing the limbus. Here main suspicious issue is any melanocytic lesion of uveal tract especially melanoma. I will refer to an ophthalmologist. While waiting to see an ophthalmologist, can be assessed by an optometrist- who knows might get some answer. Thank you.

  6. Apart from a pinguecula I am unable to see anything else. Referral to ophthalmologist if vision is affected. Drops for redness if affecting patient.

  7. This is a pretty obvious Pterygium, but what is unique / unusual is the dysplasia / in situ carcinoma! Just a reminder to be cautious, suspicious and when something “common / usual” looks a bit unusual (in this case, the abnormal / excessive blood vessels) to get a specialist opinion / tissue diagnosis

  8. There are many branching torturous blood vessels on the sclera and its clearly crossing the cornea/ limbic….it sounds as Pterygium…would refer to ophthalmologist.