This report describes a case of Vogt Koyanagi Harada Disease (VKH) in a 44-year-old male with metastatic gastric carcinoma who presented with sudden onset headache and decreased vision. The patient was treated with first-line standard therapy for stage IV HER2-positive gastric adenocarcinoma and was on maintenance trastuzumab and pembrolizumab for seven months before developing new symptoms. His VKH was diagnosed after multiple imaging and a comprehensive ophthalmologic examination. The patient’s vision and headaches improved with theinitiation of corticosteroid therapy. Although immunotherapy wasdiscontinued,trastuzumab was continuedwith close ophthalmology follow-up. He remains in stable conditiondespitehis cancer. It is critical to consider and recognize immunotherapy-relatedophthalmologic complications immediately, even if they are rare, considering theirimplications. Corticosteroids remain the first-line organ-saving therapy.
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