Metastatic Cutaneous Melanoma to the Vitreous

An 84-year-old man with history of stage IV cutaneous melanoma in remission presented with history of persistent vitreous hemorrhage of the left eye. Visual acuity on presentation was hand motion with no view posteriorly. B-scan ultrasonography showed a hyperechoic dome without significant vascularity. He underwent a diagnostic vitrectomy and was found to have extensive pigment in the vitreous and within the retinal vasculature. Pathology of the vitreous specimen was consistent with metastatic cutaneous melanoma. Despite treatment with intravitreal melphalan, the eye condition worsened and he eventually underwent enucleation.