Bilateral Harada-like reaction with bacillary layer detachment after treatment of metastatic signet ring cell carcinoma with pembrolizumab

Pembrolizumab can cause a Harada-like syndrome with bacillary layer detachment. Once the pembrolizumab is discontinued, and systemic and local corticosteroids are given, the ocular findings can resolve. Switching to a different checkpoint inhibitor may lead to a recurrence of ocular disease.