Table 1.

Timeline of the episode of care.

Timeframe	Clinical event and interventions	Findings and outcomes
~20 years prior to presentation	Patient first noticed a mass on the left eye.	A non-progressive, painless hyperpigmented mass on the left lacrimal caruncle.
1 month prior to presentation	Onset of new ocular symptoms in the right eye.	Progressive, painless visual loss in the right eye.
Initial presentation	Comprehensive ophthalmic examination, MRI of the orbit, and metastatic work-up.	Right eye (OD): hand motion vision, RAPD positive, choroidal mass with exudative retinal detachment (suggestive of melanoma). Left eye (OS): 20/20 vision, papilliform pinkish lesion overlying a hyperpigmented caruncular mass. Systemic: Metastatic work-up was unremarkable.
Surgical intervention	Conducted under general anesthesia.	OD: Enucleation. OS: Complete excisional biopsy (no-touch technique) with double freeze–thaw cryotherapy to conjunctival edges.
Postoperative pathology	Histopathological evaluation of the excised specimens.	OD: Confirmed choroidal melanoma. OS: Confirmed coexistence of a subepithelial nevus and a conjunctival papilloma.
12-month Follow-up	Clinical follow-up examination.	Patient remained stable with no evidence of tumor recurrence in either eye.

RAPD, relative afferent pupillary defect.