A large, pigmented episcleral mass is likely to be a malignant melanoma. We treated a patient with a "pseudomelanoma" that was secondary to localized silver deposition.
Report of a Case.
—An 85-year-old man presented for a routine ophthalmic examination. His pertinent history included strabismus surgery of the left eye 67 years earlier. The most significant finding was a large conjunctival and episcleral pigmented mass localized over the insertion of the left lateral rectus muscle, with a symblepharon to the left lateral canthus (Fig 1). The patient was uncertain of the lesion's duration. The mass was grayish black, showed minimal intrinsic vascularity, and did not move freely with the conjunctiva. No corresponding intraocular pigmentation was present, the conjunctiva was otherwise clear, and the remainder of the ophthalmic and general physical examination findings were unremarkable. A history of eyedropuse was indeterminate.The diagnosis was a benign pigmented episcleral lesion, related to
Bartley GB, Buller CR, Campbell RJ, Bullock JD. Pigmented Episcleral Mass From Argyrosis Following Strabismus Surgery. Arch Ophthalmol. 1991;109(6):775–776. doi:10.1001/archopht.1991.01080060031013