Suspected corneal metastasis in a case of nasopharyngeal carcinoma

A 13-year-old girl child undergoing chemotherapy for the terminal stage of undifferentiated metastatic nasopharyngeal carcinoma presented to us with a complaint of poor vision in the left eye (LE). There were no complaints of pain, photophobia, or watering. On examination, there was asymmetric optic disc pallor in both eyes with a patch of corneal infiltration in the LE that was difficult to attribute to any obvious common pathology. The richly vascular posterior segment is a well-known target of ocular metastasis for several malignancies. Corneal involvement, if it occurs, is through local spread. However in this case, in the absence of any other factors to account for this corneal infiltration along with presence of adjacent corneal neovascularization, corneal metastasis is highly suspected. Unfortunately, histopathological evidence could not be collected due to the poor general health of the patient, who did not turn up for a follow-up.