Large Subconjunctival Mass in a Patient With a History of Multiple Previous Ocular Surgeries

Abstract

A 20-year-old woman presented with complaints of blurred vision in her left eye over several weeks and a growing, bulging left-eye mass. Her history was notable for bilateral colobomas involving the iris, optic nerve, and retina; congenital cataracts after lensectomy of the left eye; retinal detachment with proliferative vitreoretinopathy of the left eye requiring a scleral buckle and silicone oil; and intractable glaucoma in the left eye requiring a superior trabeculectomy, an inferotemporal Ahmed tube implant, and multiple diode cyclophotocoagulation treatments. Because of the high risk of retinal redetachment, the silicone oil was retained throughout the glaucoma procedures. The patient presented 9 months after the last cyclophotocoagulation procedure.At presentation, she was taking dorzolamide-timolol, brimonidine, netarsudil, and latanoprost for her left eye. Best-corrected visual acuity was 20/80 OD and light perception OS. Intraocular pressures (IOPs) were 11 mm Hg OD and 20 mm Hg OS. Examination of the left eye revealed a large, firm, pink subconjunctival mass inferotemporally near the Ahmed valve (Figure 1). There was a left hypertropia of more than 45°by Hirschberg test. The anterior chamber was deep with fine silicone oil bubbles superiorly. The aphakic left eye revealed a well-positioned tube. Cup-disc ratios were 0.7 OD and 0.8 OS. The retina was centrally attached under silicone oil with a stable peripheral tractional retinal detachment.