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JAMA Ophthalmology Clinical Challenge
April 2015

Mass Obscuring the Globe

Author Affiliations
  • 1Herbert Wertheim College of Medicine, Florida International University, Miami
  • 2Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida
JAMA Ophthalmol. 2015;133(4):475-476. doi:10.1001/jamaophthalmol.2014.5091

A man in his late 30s presented to the emergency department for a left eye mass impairing his vision. He reported that he first noticed a small lesion on the nasal conjunctiva of his left eye 6 months earlier; there was rapid growth during the last 2 months. The mass became painful 4 weeks earlier and started to affect his vision 2 weeks earlier. His ocular history included enucleation of his right eye secondary to a traumatic ruptured globe 6 years previously. He denied any systemic medical problems and was not taking any medications. On examination, his visual acuity was no light perception OD (prosthesis) and light perception OS. External examination revealed a well-fitting prosthesis in the right eye with a healthy upper and lower eyelid fornix. The left eye is shown in Figure 1. An incisional biopsy was performed.