Retinoblastoma is the most common intraocular
tumor of childhood. About 95% of
retinoblastoma cases are diagnosed before the age of 5 years. Not more than 30 cases of Adult-onset
retinoblastoma have been reported in literature. A 32 year old male presented with a painful blind eye. There was sudden loss of vision accompanied by severe
pain and redness in right eye about 1 year ago, for which some surgery was done with neither a gain in vision nor any relief from
pain. Then he was put on maximum tolerable medical
therapy, later cyclocryotherapy was done. Now he presented to us with complains of extreme
pain and
bleeding from right eye since 2 days. There is no history of any ocular
trauma. Right eye had no perception of light & showed anterior staphyloma with perforation. Right
eye evisceration was done & material sent for histopathological examination, which revealed an adult-onset
retinoblastoma. CECT scan revealed thickening of optic nerve throughout its entire length with contrast enhancement. He was further taken up for enucleation of residual sclera with maximum optic nerve stump removal to reconfirm the diagnosis. Histopathological examination revealed
tumor deposits present in orbital soft tissue,
resection margins and optic nerve cut end.Retinoblastoma presenting in adult age creates a diagnostic dilemma because of its low frequency and atypical features. We want to highlight the importance of high clinical suspicion and imaging modalities before taking any patient for evisceration with unexplained vision loss. One should send the eviscerated material for histopathological examination.