Case Presentation A 59-year-old female patient presented for ophthalmic evaluation due to progressive vision loss over the past month.  Medical History Breast carcinoma (treated with surgery and long-term aromatase inhibitors: anastrozole, exemestane) Cataract surgery in the right eye six years ago Hypothyroidism, hyperlipidemia, prediabetes Ocular Examination Visual acuity: OD (right eye) 20/100, OS (left eye) 20/30 Pupils: Round, reactive to light, no relative afferent pupillary defect (RAPD) Intraocular pressure: 13 mmHg OD, 11 mmHg OS Slit-lamp examination: Clear cornea, anterior chamber, and posterior chamber intraocular lens (PCIOL) in right eye Anterior segment: Conjunctival melanosis in the right eye (superior and inferior bulbar conjunctiva) (Figure 1) Fundus examination: Bilateral bone-spicule pigmentation and vascular attenuation, optic discs preserved (Figure 2) Figure 1:…