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JAMA Ophthalmology Clinical Challenge
June 2014

A Moving Black Spot in My Vision

Author Affiliations
  • 1Department of Ophthalmology, Universidad Pontificia Bolivariana, Medellín, Colombia
JAMA Ophthalmol. 2014;132(6):769-770. doi:10.1001/jamaophthalmol.2014.317

A 22-year-old man had perceived a moving black spot in the visual field of his right eye and no other symptoms for 1 year. An ophthalmologic examination revealed visual acuity without correction of 20/20 in both eyes, and slitlamp examination findings of the right eye identified a unique lesion that was oval in shape, measured 2 mm in thickness by 2 mm in diameter, was translucent and brown, and changed its location with head posture.

During gonioscopy, we observed a nonpigmented wide angle without other findings that suggested adhesions between the lesion and the structures of the camerular angle. The patient had a clear cornea without pathologic findings, and the intraocular pressure with Goldman tonometer was 10 mm Hg in both eyes. Findings from a dilated fundus examination were unremarkable (Figure 1).

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