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JAMA Ophthalmology Clinical Challenge
June 20, 2019

A Translucent Cystic Iris Lesion

Author Affiliations
  • 1Duke Eye Center, Department of Ophthalmology, Duke University, Durham, North Carolina
JAMA Ophthalmol. 2019;137(8):951-952. doi:10.1001/jamaophthalmol.2019.1651

A boy in his teens with no significant medical history, ocular history, or recent trauma was referred by an ophthalmologist for mild photophobia and an iris lesion. The referring clinician initially suspected traumatic iridodialysis and vitreous prolapse. On ophthalmic evaluation, visual acuity was 20/20 OS, intraocular pressure was 13 mm Hg OS, and slitlamp examination of the left eye demonstrated a clear, intrinsically vascularized, cystic lesion extending into the anterior chamber from the peripheral superonasal iris (Figure 1A). The base of the lesion was surrounded by iris atrophy and corectopia was noted. The remainder of the ocular examination was unremarkable. Examination of the right eye was also unremarkable. Ultrasonographic biomicroscopy of the anterior segment demonstrated a large, cystic lesion incorporated in the iris of the left eye with a thickness of 2.2 mm and a maximum radial extent of 6.1 mm (Figure 1B).