DR. AVANI CHUDASAMA

DR. DEVENDRA K. SAXENA

Abstract

A 41-year-old man, tobacco chewer had U/L headache and B/L Dimness of vision, diagnosed with (BE) exudative RD and right sided 3rd cranial nerve palsy was sent to our hospital. OD BCVA was hand motion, OS-6/36. Provisional diagnosed VKH and started on systemic steroids by neurophysician.

Fundus: OD-Total Exudative RD with detached retina touching posterior surface of lens along choroidal lesions, OS-large choroidal lesion 5 DD size above ST arcade with localised serous detachment.

MRI ORBIT: Ill defined, extraconal lesion seen at the right orbital apex

Cytology: poorly differentiated adenocarcinoma of left lung, referred to oncology department. This case is peculiar for the unusual presentation of adenocarcinoma of lung which manifested as bilateral exudative RD mimicking VKH syndrome. Simple investigation like CXR in initial phase was not done which could have saved him from all unnecessary investigations.

Prompt diagnosis is imperative for patients to immediately initiate treatment.