The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Orbital metastasis

Photo by Dr. Ngo Chek Tung

A 84 year-old man presented with a rapid onset left proptosis and ptosis. The vision was 6/24 in the right eye and 6/60 in the left eye. A left afferent pupillary defect was present. Slit-lamp showed no choroidal masses and the intraocular pressures in both eyes were normal.

 

The patient gave a history of recurrent bleeding per rectum. A CT scan showed a left orbital mass involving the optic nerve. Colonoscopic examination and biopsy by the gastroenterologist showed an ulcerative colonic tumour. The patient would be referred to oncologist for possible orbital radiation to control the growth but before then another body scan was arranged for staging of the colonic tumour.

 

Left proptosis with ptosis.

 

Left orbital mass.

 

Colonoscopic appearance of a colonic carcinoma.

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