LAUSR

A woman in her 40s was referred to her local university for ophthalmic examination. She had been receiving care for dry eye syndrome, hyperopia, and presbyopia by another eye care clinician, and on routine examination a circumscribed elevation of her right iris was found. She noted intermittent shooting pain responsive to artificial tears in this eye; otherwise, she was without ophthalmic symptoms. She did not have any significant medical or family history, and review of symptoms was unremarkable. On examination, corrected distance Snellen acuity was 20/20 OU. Intraocular pressures were 12 mm Hg OD and 10 mm Hg OS. Slitlamp examination revealed a circumscribed elevation of the right iris inferotemporally (Figure, A). Her iris was uniformly pigmented, and gonioscopy revealed an iridocorneal angle open to scleral spur with a circumscribed area of iris insertion anterior to the Schwalbe line inferotemporally, not deepening on compression. Her lens was clear, and no iridociliary lesions were appreciated after pupillary dilation. The optic nerve and fundus appeared normal. The left eye appeared healthy with a uniformly deep anterior chamber. Ultrasound biomicroscopy of the right eye was performed, showing an inferotemporal lesion (Figure, B), with few similar-appearing lesions located in other quadrants. Slitlamp examination A Ultrasound biomicroscopy B