How are intraocular tumors of the iris diagnosed?

Updated: Jun 25, 2020
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

Benign iris melanocytic lesions and malignant lesions of the iris

Benign iris melanocytic lesions (iris nevi) are difficult to grossly distinguish from malignant lesions of the iris.

These occur as small, discrete, flat, or slightly raised nodules with variable pigmentation.

Jakobiec et al, in a study of 189 lesions of the anterior uvea, notes that 80% of clinically diagnosed melanoma of the iris cases were reclassified at pathological examination as nevi of several cell types. [2]

Another study identified 5 factors associated with higher risk of malignancy, as follows: (1) diameter greater than 3 mm, (2) pigment dispersion, (3) prominent tumor vascularity, (4) increased intraocular pressure, and (5) tumor-related ocular symptoms.

Although iris nevi rarely cause a pathologic process, diffuse growth can cause elevated intraocular pressure by direct extension into the trabecular meshwork.

The treatment of an iris nevus is the same as the treatment of a melanocytoma.


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