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JAMA Ophthalmology Clinical Challenge
September 2016

An Iris Tumor

Author Affiliations
  • 1Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
  • 2Department of Pathology, University of Michigan, Ann Arbor
  • 3University of Michigan Comprehensive Cancer Center, Ann Arbor
  • 4Ocular Oncology Service, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
  • 5Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
JAMA Ophthalmol. 2016;134(9):1063-1064. doi:10.1001/jamaophthalmol.2016.0924

A woman in her 50s noticed a gradually enlarging, white-brown, circular lesion on her right iris over the past several years but denied visual changes. She did not report trauma, changes in vision, or foreign travel and did not take any topical ophthalmic medications. Her medical history was unremarkable. Her best-corrected visual acuity was 20/25 OD and 20/20 OS. Her pupils were round with no afferent pupillary defect, although the circular lesion did move in concert with the pupillary constriction and dilation. The intraocular pressure was 14 mm Hg OU. Extraocular movements were normal. Slitlamp examination of the anterior segment showed a 2 mm × 2–mm circular iris lesion at the inferotemporal border of the iris. The mass appeared to have a fluid-debris level (Figure 1A). When the anterior segment was visualized with a goniolens (Figure 1B), we saw that the irideocorneal angle was open, that no neovascularization was present, and that a spherical mass about 2 mm in height arose from the pupillary margin. Its nasal surface appeared white with speckled-brown pigmentation, while the remainder of the lesion had brown pigment (Figure 1B). The anterior segment of the left eye and posterior segment of both eyes were unremarkable.

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