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A Rare Clinical Case of Unexplained Unilateral Vision Loss on a Background of Metastatic Breast Cancer

Jessica Boyle, BOrthOphthSc BHlthSc(Hons)1
Humayun Baig, FRCS(Edin) FRANZCO1-2
Jacqui Thomson, MBBS FRACP3

1 Heatherhill Eye Clinic, Frankston, Australia
2 Ophthalmology Department, Monash Health, Melbourne, Australia
3 Department of Medical Oncology, Peninsula Health, Frankston, Australia

A rare clinical case of unexplained unilateral vision loss occurring in a 59-year-old Caucasian female is described. The vision loss occurred in association with an ipsilateral afferent pupil defect and on a background of primary breast carcinoma with extensive bony metastases. However, there was no clinically detectable orbital infiltration, orbital pseudo-tumour, compressive visual pathway lesion, optic neuritis or retinal pathology that could account for the ocular symptomatology. The patient was receiving palliative oral capecitabine chemotherapy at the time of presentation. Findings on clinical examination, perimetry testing, fundus photography, optical coherence tomography and magnetic resonance imaging are presented. Other differential diagnoses underlying this case of severe, sub-acute vision loss are discussed

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