Iris Melanomas Flashcards
Describe iris nevi
How common is it, is it flat, typical size, is there vascularization (ectropian) or pupil distortion?
- very common
- flat hyperpigmented areas
- typically 3 mm in diameter
- mild/no vascularization (ectropian) or pupil distortion
Describe iris melanoma
(More common in light/dark irides?, slow/fast growing, neovascularization and pupil distortion?, what is it secondary disease?)
- more common with light irides
- slow growing
- neovascularization and pupil distortion
- secondary glaucoma and cataracts
Describe iris melanoma
benign/malignant?, age onset, pigmented/non-pigmented, smooth/irregular?
- most iris tumors are benign
- average onset 40-50 years
- pigmented or non-pigmented
- smooth or irregular
Describe a circumscribed melanoma
shape, location in iris, appearance in AC or Post Chamber, what diagnostic test can be performed
- nodular shape
- seen in inferior iris
- “lion’s paw” appearance in AC or Post. chamber
- can invade ciliary body
- Can check with Gonioscopy and ultrasound biomicroscopy
Describe diffused melanoma
shape, location in iris, appearance in AC or Post Chamber, what diagnostic test can be performed
- causes acquired heterochromia
- associated glaucoma, runs poorly to Tx (causes severe cupping and functional loss)
- higher risk of metastasis
Describe primary iris cysts (epithelial and stromal)
Epithelial: shape, does it transilluminate, where is it located?
Stromal: what age group, clear?, fluid filled?
- mostly stational and asymptomatic
- Epithelial cysts: globular, dark brown, transilluminates, around the pupil border, midzone or peripheral
Stromal cysts: in children, clear anterior wall, fluid filled
Describe secondary cyst
Secondary to what?, is it fluid filled, does it have a clear anterior wall, what happens when it enlarge
- secondary to post surgery, ocular trauma or long acting miosis
- fluid filled anterior wall
- enlarge (uveitis and glaucoma)
What tests are used to diagnose iris cysts?
ultrasonagraphy?, SLE?, follow up for what pathology?
- High frequency ultrasonagraphy
- slit lamp exams
- periodic observation to watch for secondary angle closure glaucoma and synchronous ciliary body necroplasia
What is the treatment for iris cysts?
Most common treatment and treatment for secondary glaucoma
- most iris cysts require no treatment
- treatment in instances of secondary glaucoma or when pupil becomes blocked
- laser can deflate iris cyst
You see a spot on the iris that has a “lion’s paw” appearance in the posterior chamber. What is the most likely diagnosis?
A. Circumscribed melanoma B. Diffuse melanoma C. Epithelial Iris Cyst D. Stromal iris cyst E. Secondary Iris Cyst
A. Circumscribed melanoma
You see a spot on the iris that has given the patient acquired heterochromia. What is the most likely diagnosis?
A. Circumscribed melanoma B. Diffuse melanoma C. Epithelial Iris Cyst D. Stromal iris cyst E. Secondary Iris Cyst
B. Diffuse melanoma
You see a spot on the iris that appears globular and dark brown and transilluminate under a SLE. The patient reports no symptom. What is the most likely diagnosis?
A. Circumscribed melanoma B. Diffuse melanoma C. Epithelial Iris Cyst D. Stromal iris cyst E. Secondary Iris Cyst
C. Epithelial Iris Cyst
You have a 6 year old child that fluid filled spot on their iris with a clear anterior wall. The patient reports no symptom. What is the most likely diagnosis?
A. Circumscribed melanoma B. Diffuse melanoma C. Epithelial Iris Cyst D. Stromal iris cyst E. Secondary Iris Cyst
D. Stromal iris cyst
You have a patient that has a fluid filled spot on their iris with a clear anterior wall that occurred after using excessive miotics What is the most likely diagnosis?
A. Circumscribed melanoma B. Diffuse melanoma C. Epithelial Iris Cyst D. Stromal iris cyst E. Secondary Iris Cyst
E. Secondary Iris Cyst
