Hindsight Is 20/20

Abstract A 17-year old male presented to the emergency department initially with abdominal pain and headache which progressed to neck swelling and vision changes over a period of several weeks. He was noted to have a 4 cm by 4 cm right supraclavicular lymph node and visual acuity of 20/200 in the right eye and 20/70 in the left eye. Further testing, imaging, and a thorough history revealed the source of his illness and unusual ophthalmologic findings.