Tapioca iris melanoma masquerading as unilateral glaucoma.
Denis Nevrov, Fiona D'Arcy, Susan Kennedy et al.
✦ AI-curated · Sources linked
Case in brief
A woman in her mid-70s presented with uncontrolled intraocular pressure in her right eye, unresponsive to multiple surgical interventions and topical therapy, while her left eye remained normal. Examination revealed fluffy deposits in the anterior chamber and vitreous debris. Ultrasound biomicroscopy indicated diffuse thickening of the iris and ciliary body. Subsequent biopsy confirmed melanoma, leading to enucleation that revealed extensive involvement and extrascleral extension.
What made this case unusual
The case highlights the diagnostic challenge posed by lightly pigmented diffuse 'tapioca' iris melanoma, which can mimic unilateral glaucoma.
Diagnostic / clinical pearl
Clinicians should consider the possibility of iris melanoma in cases of unexplained unilateral glaucoma, especially when typical treatments fail.
Why it matters
This case emphasizes the critical role of ultrasound biomicroscopy in the evaluation of atypical presentations of glaucoma.