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Melanocytoma, a benign uveal melanocytic tumour, represents only 3% of iris naevi, and seldom undergoes malignant transformation.1 2 We report an unusual case of an iris melanocytoma suggested by two separate biopsies, which evolved into ring melanoma of the iris.
A 33-year-old Caucasian female, with a family history of open-angle glaucoma, presented with ‘darkening of the left eye’ since the age of 16 years, left hemicranial headache for 18 months and reduced vision in the left eye for 2 days. Visual acuity was 6/9 with a left relative afferent pupillary defect. There was left heterochromia iridis, with patchy iris hyperpigmentation (fig 1A), that was flat except for one inferonasal area. Intraocular pressure (IOP) was 50 mm Hg. Gonioscopy revealed the drainage angle to be hyperpigmented. The optic disc had a cup:disc ratio of 0.9 with a disc haemorrhage. Visual field tests (Humphrey 24-2) confirmed an obliterated field. …