Complete Junctional Scotoma Secondary to Metastatic Melanoma: A Rapidly Progressive Presentation

Junctional scotomas are distinctive visual field defects caused by lesions at the junction of the optic nerve and optic chiasm. The classic presentation includes ipsilateral vision loss with a contralateral superior temporal field deficit. A complete junctional scotoma involves more extensive damage, resulting in visual field loss across the entire contralateral temporal field. We present the case of a woman in her 30s with a recent diagnosis of metastatic melanoma who developed unilateral vision loss that progressed to a complete junctional scotoma within three days. Her symptoms were rapidly evolving and included trigeminal sensory changes and cranial nerve involvement. This case highlights the importance of visual field testing and thorough neurological examination in lesion localization. Although rare, metastatic tumors such as melanoma can produce aggressive neuro-ophthalmologic deficits, necessitating prompt recognition and intervention.