A woman’s blindness in her right eye turned out to have an unexpected and frightening cause: metastatic lung cancer. Doctors in India reported the strange occurrence last month—seemingly the first of its kind ever documented.
The case was described in a paper published in Radiology Case Reports in early April. According to the report, the 32-year-old woman visited doctors 20 days into losing vision in her right eye. She also occasionally saw flashes of light in her left eye. These symptoms, however, weren’t accompanied by any pain or redness in her eyes. A physical examination revealed the presence of a large lesion in the right eye that appeared to detach the retina, along with a smaller lesion in the left eye.
The woman showed no signs of an ongoing infection, immune disorder, or anything else that would easily explain her predicament. But the doctors knew that there are certain lung-related conditions that rarely cause vision problems, such as tuberculosis infection, so they decided to X-ray the woman’s chest as well as get a CT scan of her entire body. The scans showed a primary malignant mass in the woman’s lungs, along with secondary tumors scattered around her body, including in her eyes.
Tumors in the eyes are thought to be most often caused by cancers that have spread from elsewhere in the body. But it’s “extremely rare” for vision impairment to be the leading symptom of a person’s advanced lung cancer, the doctors note. As far as they were able to find, there have only been around 60 such cases ever described in the medical literature. But even these cases have tended to involve people with known risk factors for lung cancer, such as being older or having a history of smoking. Stranger still is that the woman’s blindness appeared to be the first sign of her lung cancer.
“To our knowledge, this is the first case where visual disturbance was a presenting and only manifestation of lung carcinoma in a mid-age, nonsmoker female,” they wrote.
While rare, the woman’s case is evidence that doctors should be willing to consider the possibility of lung cancer when they encounter eye lesions in their patients that can’t be explained by other things, the authors say. It’s known that some lung cancer patients can experience little to no symptoms for a long time, even when the cancer starts to spread further, and the authors say that more research needs to be done to understand how this can happen. Either way, they argue that such “patients represent an important and distinct subset” of lung cancer cases.
As for the woman, she was referred to an oncologist for cancer treatment by the doctors, but no further details on her condition were later provided.
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