A Man with Vision Loss in the Left Eye

Imaging suggested that the lung cancer had metastasized to the liver, adrenal gland, brain, and lymph nodes of the neck. The patient’s visual symptoms included floaters and pain; examination showed visual acuity of 20/80 in the left eye, along with vitritis and a large retinal lesion with hemorrhage, retinal thickening, and hard exudates (Figure 1). He received treatment for presumed cytomegalovirus (CMV) retinitis, but a 2-week follow-up exam showed no lesion improvement. He subsequently underwent vitrectomy and retinal biopsy; pathology showed retinal metastases of his small-cell lung cancer.