Case Report: Asymmetric Visual Field Progression in Melanoma-Associated Retinopathy Heralding Recurrent Malignancy.

Purpose: To report a case of asymmetric melanoma-associated retinopathy (MAR) associated with metastatic melanoma which was thought to be in remission for 6 years. Identification of MAR led to the discovery of recurrent malignancy.

Method: A man in his 60s presented with monocular visual disturbances with a large relative afferent pupillary defect, rapidly progressing visual field defect and otherwise normal eye examination.

Progressive sixth nerve palsy secondary to intracavernous arachnoid cyst and complicated by contralateral optic nerve sheath meningioma.

Introduction: Optic nerve sheath meningiomas and intracavernous arachnoid cysts are both fairly rare conditions, and to the best of our knowledge, have not been previously reported to co-occur in the same patient. Both can cause diplopia, but only ONSMs have been documented to demonstrate progressive worsening of ocular motility.

Case Report: A 67-year-old woman with blur and diplopia demonstrated a right optic neuropathy and limited ductions bilaterally.