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First Author: V.Ho UK
Co Author(s): A. Kamal
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To describe a rare case of retinal granuloma in a 73-year-old man who has a history of previous ocular trauma.
Aintree University Hospital, Eye department, Liverpool, United Kingdom
We report a case of a 73-year-old man who was found to have a raised retinal lesion in his left amblyopic eye by an optician on a routine eye examination. He was asymptomatic and gave a history of trauma in the same eye and had subsequent surgery 40 years ago. Visual acuity was 6/9 in the right and 6/36 in the left. Both the anterior segments were quiet and the intraocular pressures were normal. Fundi examination of the left eye showed a solitary raised, pale yellow lesion surrounded by small amount of pigment clumping, situated nasally to the optic disc. No abnormalities were found in the right eye. Ocular ultrasounds scan showed a hyperechoeic mass at the left posterior pole.
As patient was asymptomatic and the affected eye being an amblyopic eye, a conservative approach was adopted. Patient was discharged after two years of observation with no change in size and appearance of the lesion.
The formation of a retinal granuloma can occur following previous ocular trauma or surgery, which could remain quiescent for a long period of time. However, important differential diagnosis should include foreign body, retinal cyst, retinoschisis, choroidal melanoma, infective causes or granulomatous inflammatory disease. This would help guide for further investigation and subsequent management.