False about primary intraocular lymphoma
**Core Concept**
Primary intraocular lymphoma (PIOL) is a rare, aggressive malignancy involving the eye, primarily affecting the uvea. It is a type of non-Hodgkin lymphoma that originates within the eye, often presenting with symptoms such as vision loss, floaters, and retinal detachment.
**Why the Correct Answer is Right**
PIOL typically presents with unilateral involvement, with the majority of cases affecting the posterior uvea. The disease often masquerades as other uveitic conditions, such as sarcoidosis or toxoplasmosis, making early diagnosis challenging. The presence of lymphoma cells in the vitreous or aqueous humor is a hallmark of PIOL, which can be confirmed by cytological examination or biopsy. Treatment typically involves a combination of chemotherapy and local therapy, such as radiation or intravitreal injections.
**Why Each Wrong Option is Incorrect**
**Option A:** PIOL is typically a bilateral disease. **Incorrect**, as PIOL is usually unilateral.
**Option B:** PIOL is a common cause of uveitis. **Incorrect**, as PIOL is a rare cause of uveitis, often masquerading as other conditions.
**Option C:** PIOL is primarily a disease of the anterior uvea. **Incorrect**, as PIOL primarily affects the posterior uvea.
**Clinical Pearl / High-Yield Fact**
PIOL often presents with a "snowball on the beach" appearance on fundoscopy, characterized by a retinal mass with surrounding retinal detachment.
**Correct Answer: C. PIOL primarily affects the posterior uvea.**