# Choroidal Metastasis as a Presenting Feature of Lung Cancer in a Patient Presenting With Sudden-Onset Bilateral Loss of Vision: A Case Report

## TL;DR

A case report shows that sudden vision loss can be an early sign of advanced lung cancer spreading to the eyes.

## Contribution

This case emphasizes the importance of recognizing ocular symptoms as potential indicators of undiagnosed advanced cancer.

## Key findings

- Choroidal metastases were identified as the initial presentation of advanced lung cancer in a patient with sudden vision loss.
- The patient's poor clinical status precluded biopsy, and she received palliative care before passing away within two weeks.
- The case underscores the need for thorough evaluation of ocular symptoms to detect underlying systemic malignancies.

## Abstract

Choroidal metastases are a rare but significant presentation of lung cancer, often indicating advanced disease and associated with poor prognosis. This report describes a 61-year-old woman with chronic obstructive pulmonary disease and a heavy smoking history who presented with sudden bilateral vision loss. Ophthalmic evaluation revealed bilateral choroidal metastases with exudative retinal detachment. Imaging identified a right hilar lung mass with widespread metastases. Due to her poor clinical status, biopsy was not feasible, and she received palliative care. She died within two weeks of presentation. This case highlights the importance of considering ocular symptoms as possible initial signs of occult and usually advanced systemic malignancy, necessitating a thorough history taking, examination and relevant investigations to identify distant malignancy and what treatment options may be offered to the patient.