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JAMA Ophthalmology Clinical Challenge
April 2018

A Case of Progressive Dimming Vision

Author Affiliations
  • 1Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
  • 2Department of Ophthalmology, Stanford University Medical Center, Palo Alto, California
JAMA Ophthalmol. 2018;136(4):434-435. doi:10.1001/jamaophthalmol.2017.4162

A man in his early 70s with 2 months of progressive dimming of his vision was referred for evaluation. He initially presented to his primary care physician reporting unintentional weight loss, fevers, and subacute visual decline. Subsequent ophthalmic examination revealed mild anterior and posterior inflammation, raising suspicion for panuveitis. Results of laboratory tests for sarcoidosis, Lyme disease, and syphilis were negative. However, a right upper lobe lung mass noted on the chest radiograph proved to be T2N2M0 stage III non–small-cell lung cancer on biopsy.

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