The above are Optos fundus images of right and left eyes.
They belong to a female patient who presented to eye casualty with symptoms of blurred vision and floaters.
- What is your diagnosis?
- What questions would you ask during history taking?
ANSWER
Diagnosis: Primary ocular/CNS lymphoma
History: Systemic symptoms, prior illnesses
PMH: This patient had received chemotherapy for primary CNS lymphoma after confirmation via brain biopsy. Subsequent MRI was clear.
Examination: In addition to the fundus findings, WBC sheaths in the vitreous are seen.
Management of the ocular condition: Confirmation biopsy has been requested such as a choroidal biopsy. However, referral to Liverpool, based on clinical findings alone, has been made.