Red eye and a rodent ulcer

Ophthalmic Plast Reconstr Surg. Mar-Apr 2006;22(2):131-2. doi: 10.1097/01.iop.0000199237.86504.ab.


A 58-year-old woman presented with a 1-week history of poor vision in the right eye associated with a red eye. She was transferred for vitreoretinal management of suspected endophthalmitis. On examination, she had extensive ulceration of her forehead, exposing a pulsating mass covered with white antiseptic powder. The ulcer extended to involve the nose and right upper eyelid. Computed tomography demonstrated widespread erosion of the frontal bone, exposing the dura; histopathology confirmed the lesion to be basal cell carcinoma. The ulcer had slowly progressed for 30 years, but the patient was in denial about her condition. She had kept the ulcer well hidden by combing her hair forward over it. She was married, with an adult child, and was employed as a courier. Despite three assessments of her eye by medical staff in the preceding 24 hours, the diagnosis of the extensive basal cell carcinoma had been missed as she had refused to lift her hair for a complete examination.

Publication types

  • Case Reports

MeSH terms

  • Bone Diseases / diagnostic imaging
  • Bone Diseases / pathology*
  • Carcinoma, Basal Cell / diagnostic imaging
  • Carcinoma, Basal Cell / secondary*
  • Carcinoma, Basal Cell / surgery
  • Conjunctivitis / pathology*
  • Corneal Ulcer / pathology*
  • Diagnosis, Differential
  • Eyelid Neoplasms / diagnostic imaging
  • Eyelid Neoplasms / secondary*
  • Eyelid Neoplasms / surgery
  • Female
  • Frontal Bone / diagnostic imaging
  • Frontal Bone / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / pathology*
  • Tomography, X-Ray Computed