Diagnostic dilemma of ocular lymphoma.

We report a very unusual presentation of primary intraocular lymphoma masquerading as anterior uveitis with atypical symptoms. A 68-year-old man, initially presented with a 4-day history of painless, left blurred vision. Examination revealed 2 or more anterior chamber cells, mutton-fat keratic precipitates and posterior synechiae. Treatment was initiated, the eye settled, and the patient was discharged. He re-presented 7 months later with hypopyon, a hazy cornea, fibrin deposits and a narrowed anterior chamber angle. Over the coming weeks, it became apparent that the temporal iris was thickened, involving the angle, and his intraocular pressure increased despite topical dorzolamide. Following advice from a tertiary centre and referral to a regional ocular oncology centre, a transscleral biopsy was performed and suggested a ciliary body melanoma. Enucleation was advised and performed, with histological examination revealing features consistent with an ocular diffuse large B-cell lymphoma not involving the optic nerve, sclera or cornea. This is the first ever published report of a case of ocular lymphoma masquerading in this way.

'The nodule that disappeared' spontaneous regression of an eyelid noduloulcerative lesion mimicking the features of a basal cell carcinoma.

We describe a case of a clinically apparent basal cell carcinoma (BCC) with spontaneous regression. Histological confirmation of the diagnosis was not possible, and an immunological basis for regression is presumed. The understanding of such immunologically mediated regression of BCCs could provide future therapeutic targeting and research is ongoing.

Asymptomatic snowflake degeneration in a polymethyl methacrylate (PMMA) intraocular lens implant.

Snowflake degeneration is a late complication of polymethyl methacrylate (PMMA) intraocular lens implants. We report a case of asymptomatic advanced snowflake opacification presenting 13 years after implantation who maintained a visual acuity of 6/6. This report serves to illustrate the variability of the clinical effects of snowflake degeneration, which do not necessarily correlate with slit-lamp appearances.

Anterior uveitis, poliosis, and skin hypopigmentation associated with topical chloramphenicol allergy following ptosis surgery.

The association of uveitis and vitiligo has long been established in specific disease entities: Vogt-Koyanagi-Harada syndrome and sympathetic ophthalmia. We report an unusual case of topical chloramphenicol allergy associated with an anterior uveitis with subsequent poliosis and periocular vitiligo, following anterior approach levator advancement surgery.

Osteosarcoma after external beam radiation therapy for recurrent choroidal melanoma.

A 59-year-old woman underwent enucleation for choroidal melanoma. She had a late recurrence of the melanoma, which was treated with surgery and radiotherapy. Nine years after radiation treatment, she presented with pain and an orbital mass. Biopsy of the mass revealed an osteoblastic osteosarcoma. This report describes the late recurrence of choroidal melanoma and subsequent radiation-induced osteosarcoma. The risk of radiation-induced malignancy should be considered in all patients receiving radiotherapy. Despite yearly review, osteosarcoma was diagnosed only when the patient had symptoms, thus raising questions about the merits of long-term follow-up in detecting recurrence or emergence of secondary tumors.