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

Figure 1 Figure 2 Figure 3

Photos courtesy of: Carol L. Shields, M.D. Used with permission. Not to be reproduced.

A 56-year-old white woman was noticed to have a dark spot in her left eye with no significant sytemic history. Best corrected vision was 6/6 in both eyes. Right eye examination was unremarkable. Left eye examination revealed a non-pigmented lesion in the anterior chamber angle which measured nearly 5 mm in diameter and contained intrinsic vessels [Fig. 1]. Gonioscopy is shown in Fig. 2 and transillumination showed no shadow in the ciliary body region. Ultrasound showed a lesion measuring 2 mm in thickness and 5 mm in base [Fig. 3]. Fundus examination was normal in both eyes.

1.	What is the most probable diagnosis?
	a. iris nevus b. iris melanocytoma c. iris ciliary body melanoma d. none of the above
2.	Risk factors in favor of above lesion to be malignant:
	a. choroidal nevus b. vessels within the lesion (intrinsic vessels) c. all of the above d. none of the above
3.	The most suitable treatment for this case is:
	a. observation b. biopsy and further management decisions depending upon the histopathology c. partial lamellar sclerouvectomy (PLSU) d. plaque radiotherapy

For answers to the above, click here on or after May 6, 2008.