Primary Choroidal Melanoma in a 30-year-old Woman with Monocular Flashers

TL;DR

A 30-year-old woman with blurry vision and flashers was diagnosed with choroidal melanoma using ultrasound and eye exams, emphasizing the importance of early detection.

Contribution

This case demonstrates the utility of point-of-care ultrasound and funduscopic examination in early choroidal melanoma detection.

Findings

Point-of-care ultrasound identified retinal detachment and an underlying mass.

Fundoscopic examination revealed hyperpigmented lesions consistent with choroidal melanoma.

Early diagnosis led to timely referral to ophthalmology for confirmation.

Abstract

An otherwise healthy, 30-year-old female was referred to the emergency department by a local optometrist after having flashers and blurry vision for two weeks. Point-of-care ultrasound revealed partial retinal detachment with underlying mass, and dilated fundoscopic examination suggested hyperpigmented lesions. Ophthalmology was consulted, and the diagnosis of amelanotic choroidal melanoma was confirmed.

Choroidal melanoma is the most common primary malignant tumor in the eye, but its diagnosis is often delayed due to non-specific symptoms. Early identification is crucial given relatively high rates of metastasis. This case highlights how a tentative diagnosis, made using point-of-care ultrasound and funduscopic examination, can drive timely referral to ophthalmology.

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