To see views enlarged, click on the individual pictures...

This is a 55-year-old white male who presented to an optometrist complaining of an enlarging "black spot" on his left eye. He had 20/30 vision (sc) and a lesion as depicted. He was subsequently referred to a retina specialist.

1.	What is the most likely diagnosis?
	a. ciliary staphyloma b. benign iris cyst c. iris nevus d.  ciliary body melanoma e. melanocytoma of ciliary body f. sarcoidosis
2.	Which of the following would NOT be useful in the DIAGNOSIS?
	a. ultrasound biomicroscopy b. careful slit lamp examination c. tonometry d.  gonioscopy e. dilated funduscopic exam
3.	What ancillary study is warranted in this patient?
	a. homocystine level b. ACE/lysozyme c. abdominal ultrasound d.  complete skeletal survey e. urethral swab
4.	Which finding would be MOST worrisome?
	a. low-to-medium reflectivity of internal spikes (on ultrasound) b. normal IOP c. 20/30 vision d.  lysozyme level of 11.0 mg/dl e. regular iris architecture
5.	What is the recommended treatment?
	a. observation b. photocoagulation c. enucleation d.  radiotherapy

For answers to the above, click here on or after January 23, 2007.