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Ophthalmic Images
September 13, 2018

Bilateral Iris Metastasis From Pulmonary Adenocarcinoma

Author Affiliations
  • 1State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
JAMA Ophthalmol. 2018;136(9):e182381. doi:10.1001/jamaophthalmol.2018.2381

A man in his 60s presented with blurred vision without pain for 1 month. Visual acuity was 20/40 OU, and intraocular pressure was 37 OD and 46 OS. The patient was diagnosed with histopathologically confirmed pulmonary adenocarcinoma with multiple metastases including in his brain. On examination, semitransparent, jellylike iris neoplasms of varying sizes and shapes were found in multiple quadrants of both eyes (Figure). The anterior chamber angles were opened in both eyes by gonioscopy. Dilated fundus examination, ultrasonography, optical coherence tomography, and ultrasonography biomicroscopy revealed no neoplasms in the ciliary body or choroid. The patient was treated with gefitinib and topical antiglaucoma medications.

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