University of Iowa Health Care

Ophthalmology and Visual Sciences

EyeRounds.org

Iris Melanoma

Contributor: David A. Ramirez, MD; Mark A. Greiner, MD

Photographer: Jody Troyer, CRA; Laura Fuhrmeister

Category(ies):

  • Cornea/External Eye Disease
  • Glaucoma/Iris

Posted September 23, 2019

93-year-old woman presented with progression of longstanding iris nevus. Her original presentation in 2005 is shown in Figure 1. Figures 2 and 3 demonstrate frank enlargement of the primary lesion at 6 o'clock and local metastasis, with erosion through the angle into the sclera at 8o'clock (Figures 4 and 5). Pigmented keratic precipitates are suspicious for anterior chamber seeding (Figure 6). High frequency anterior segment imaging demonstrates further angle invasion (arc of high reflectivity; Figure 7).

Primary lesion presentation

Figure 1. Primary lesion presentation, 2005

Evolution of primary lesion

Figure 2. Evolution of primary lesion, 2019

Elevation of the iris melanoma

Figure 3. Elevation of the iris melanoma

Invasion of the iris melanoma through the sclera, with overlying conjunctiva.

Figure 4. Invasion of the iris melanoma through the sclera, with overlying conjunctiva

Dense pigmentary infiltration of the angle

Figure 5. Dense pigmentary infiltration of the angle

Pigmented keratic precipitates on the corneal endothelium, thought secondary to melanoma seeding the anterior chamber.

Figure 6. Pigmented keratic precipitates on the corneal endothelium, thought secondary to melanoma seeding the anterior chamber.

High frequency anterior segment ultrasonography showing high internal reflectivity, suspicious for malignancy, in the area of the lesion.

Figure 7. High frequency anterior segment ultrasonography showing high internal reflectivity, suspicious for malignancy, in the area of the lesion.


Contributor: Andrew Doan, MD, PhD, University of Iowa

see Case 25

Category: Glaucoma / Iris

Posted February 8, 2008

3 patients with iris melanomas. The last patient had a recurrence 20 years later after an iridocyclectomy.

iris melanoma

iris melanoma

iris melanoma

iris melanoma


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last updated: 09-23-2019
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