Small lymphocytic lymphoma presenting as bilateral medial lower eyelid ectropion

Purpose: Herein, we present a case of new-onset medial ectropion of the lower eyelids and persistent painless cervical lymphadenopathy in an 85-year-old man highlighting a unique presentation of small lymphocytic lymphoma (SLL). Observations: Physical examination revealed bilateral medial ectropion with associated follicular changes to the palpebral conjunctiva and extensive cervical lymphadenopathy. Conjunctival biopsies were taken during ectropion repair in addition to fine needle biopsy of the cervical lymphadenopathy which both independently confirmed a diagnosis of SLL. Surgical intervention, including bilateral lateral tarsal strip and medial spindle procedures, yielded excellent postoperative outcomes. Given the patient's staging, he remained under observation until treatment was warranted to address progressive lymphadenopathy. Conclusions and importance: This report contributes valuable new insight into the ocular manifestations of lymphoproliferative disease.