Dr.Yazhini, T16185
Purpose:To report unexpected occurrence of rare malignant tumour in painful blind eye.The possible complications of inadvertent evisceration is emphasised.Method:A patient with granulomatous uveitis presented with sudden proptosis,no light perception and restriction of ocular movements of right eye.B scan done and diagnosis of panophthalmitis made and evisceration done.Histopathological examination(HPE) showed Adenocarcinoma of Retinal Pigment Epithelium(RPE).MRI revealed tumour in right orbit.He underwent exenteration of right orbit.HPE of the exenterated tissue confirmed RPE Adenocarcinoma.Distant metastasis ruled out.Conclusion:This is the first reported case of Primary RPE adenocarcinoma presenting as painful blind eye.Literature review revealed malignant melanoma to present as an occult neoplasm in painful blind eye.The clinical picture and the B Scan of this patient were misleading.High index of suspicion of rare possibilities is warranted in cases with unusual presentations.
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