{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:31:06Z","timestamp":1756384266001,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,10]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>A 49-year-old gentleman presented with a 1-day history of painful deterioration of vision in his right eye. He was lifting heavy weights just before this visual loss. On examination, his vision was perception of light in that eye, with a medically uncontrollable high intraocular pressure and hyphaema almost completely filling his anterior chamber. An ultrasound performed suggested a working diagnosis of a Valsalva related \u2018eight ball\u2019 bleed. After an anterior chamber washout, he had another episode of bleeding three days later. A pars plana vitrectomy was performed and the sample obtained was sent off to the laboratory, revealing a choroidal melanoma. Following enucleation, the histology confirmed a large necrotic spindle cell melanoma, with a haemorrhagic background. Fortunately, no liver metastasis was found. Since his diagnosis 3 years ago, he continues to be followed up in an artificial eye clinic and has regular liver scans under the care of his oncologist.<\/jats:p>","DOI":"10.1136\/bcr-2020-240983","type":"journal-article","created":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T11:11:44Z","timestamp":1622113904000},"page":"e240983","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual presentation of a choroidal melanoma"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4061-4608","authenticated-orcid":false,"given":"Sunila","family":"Jain","sequence":"first","affiliation":[{"name":"Ophthalmology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, Lancashire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kar Yen","family":"Phoong","sequence":"additional","affiliation":[{"name":"The University of Manchester, Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,27]]},"reference":[{"key":"2025082623565709000_14.5.e240983.1","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1001\/jamaophthalmol.2015.0887","article-title":"Long-Term risk of Melanoma-Related mortality for patients with uveal melanoma treated with proton beam therapy","volume":"133","author":"Lane","year":"2015","journal-title":"JAMA Ophthalmol"},{"key":"2025082623565709000_14.5.e240983.2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.03-0538"},{"key":"2025082623565709000_14.5.e240983.3","doi-asserted-by":"crossref","unstructured":"Sundaram V , Barsam A , Barker L . Oxford specialty training: training in ophthalmology. 2nd edn. America: Oxford University Press, 2016: 190.","DOI":"10.1093\/med\/9780199672516.001.0001"},{"key":"2025082623565709000_14.5.e240983.4","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1097\/IAE.0b013e31824d09a8","article-title":"Clinical spectrum and prognosis of uveal melanoma based on age at presentation in 8,033 cases","volume":"32","author":"Shields","year":"2012","journal-title":"Retina"},{"key":"2025082623565709000_14.5.e240983.5","unstructured":"EyeRounds . Posterior uveal (ciliary body and choroidal) melanoma, 2010. Available: https:\/\/eyerounds.org\/cases\/117-posterior-uveal-melanoma.htm"},{"key":"2025082623565709000_14.5.e240983.6","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0161-6420(80)35197-X","article-title":"Malignant melanoma. Analysis of an autopsy population","volume":"87","author":"Zakka","year":"1980","journal-title":"Ophthalmology"},{"key":"2025082623565709000_14.5.e240983.7","unstructured":"Salmon JF . Kanski\u2019s clinical ophthalmology: a systematic approach. 9th edn. United Kingdom: Elsevier, 2020: 847\u20139."},{"key":"2025082623565709000_14.5.e240983.8","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1016\/S0161-6420(87)33537-7","article-title":"Prevalence and mechanisms of secondary intraocular pressure elevation in eyes with intraocular tumors","volume":"94","author":"Shields","year":"1987","journal-title":"Ophthalmology"},{"key":"2025082623565709000_14.5.e240983.9","first-page":"1245","article-title":"Incomplete spontaneous regression of choroidal melanoma associated with inflammation","volume":"117","author":"Shields","year":"1999","journal-title":"Arch Ophthalmol"},{"key":"2025082623565709000_14.5.e240983.10","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1016\/S0161-6420(92)31744-0","article-title":"Scleritis as an initial manifestation of choroidal malignant melanoma","volume":"99","author":"Yap","year":"1992","journal-title":"Ophthalmology"},{"key":"2025082623565709000_14.5.e240983.11","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1979.01020020053012"},{"key":"2025082623565709000_14.5.e240983.12","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.ajo.2003.08.044","article-title":"Hemorrhagic complication in an unsuspected macular choroidal melanoma","volume":"137","author":"Chan","year":"2004","journal-title":"Am J Ophthalmol"},{"key":"2025082623565709000_14.5.e240983.13","first-page":"298","article-title":"Valsalva hemorrhagic retinopathy","volume":"70","author":"Duane","year":"1972","journal-title":"Trans Am Ophthalmol Soc"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-240983","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:57:06Z","timestamp":1756277826000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-240983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":13,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,27]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bcr-2020-240983"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-240983","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}