Case of the month

A 38 year old female presented for her annual eye exam with a complaint of decreased vision at intermediate and near distances for the past 8 months. Her last eye exam was ten years ago with normal findings. No previous ocular or medical history was noted. No family ocular or medical history was noted. Visual acuities without correction were 20/20 in the right eye and 20/25 in the left eye. Anterior segment findings were unremarkable. Posterior segment findings revealed multiple small hyperpigmented lesions inferiorly in the right eye and nasally in the left eye, with one larger teardrop-shaped lesion in the right eye. Autofluorescence photos of the lesions can be seen in Figure 1 above.

Based on the retinal findings, what is the next step for management of this patient? *

A- Refer to specialist for ocular melanoma evaluation
B- Refer for gastroenterological work up
C- Complete uveitis lab work up
D- No further work up is necessary; monitor annually

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Case of the Month - March 2020