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Photo Essay
March 1999

Retained Intraocular Metallic Foreign Body Masquerading as a Ciliary Body Melanoma With Extrascleral Extension

Arch Ophthalmol. 1999;117(3):410. doi:10.1001/archopht.117.3.410

A 77-YEAR-OLD white man was referred to the Nashville Veterans Administration Medical Center in Tennessee for further evaluation and management of a pigmented scleral nodule resembling extrascleral extension of a ciliary body melanoma (Figure 1). Findings from slitlamp and dilated funduscopic examination of the left eye were unremarkable except for the 1.4 × 1.5-mm slightly elevated and heavily pigmented scleral lesion, which was in close proximity to the limbus. Findings from careful gonioscopic examination revealed a pigmented mass in the angle surrounded by atypical orange-brown pigmentation resembling a rust ring (Figure 2). On questioning, the patient recalled being hit in the eye with a metal fragment while working on the construction of a bridge 30 years earlier. Routine orbital radiography (Figure 3) and anterior segment B-scan ultrasonography (Figure 4) revealed a metallic foreign body. There was no evidence of ocular siderosis.