Choroidal Metastasis as a Presenting Feature of Lung Cancer in a Patient Presenting With Sudden-Onset Bilateral Loss of Vision: A Case Report

Choroidal metastases are a rare but significant presentation of lung cancer, often indicating advanced disease and associated with poor prognosis. This report describes a 61-year-old woman with chronic obstructive pulmonary disease and a heavy smoking history who presented with sudden bilateral vision loss. Ophthalmic evaluation revealed bilateral choroidal metastases with exudative retinal detachment. Imaging identified a right hilar lung mass with widespread metastases. Due to her poor clinical status, biopsy was not feasible, and she received palliative care. She died within two weeks of presentation. This case highlights the importance of considering ocular symptoms as possible initial signs of occult and usually advanced systemic malignancy, necessitating a thorough history taking, examination and relevant investigations to identify distant malignancy and what treatment options may be offered to the patient.