Untreated IRIS melanoma complicated by hyphema and uncontrolled glaucoma responsive to IODINE-125 brachytherapy

Purpose: To describe a case of iris melanoma for which a patient refused treatment for 15 years, and the complications that resulted. Methods: Single case report. Results: A 52-year-old white man was evaluated for a suspicious pigmented lesion of the left iris. He was followed closely with serial examinations and ultrasound biomicroscopy, and he refused therapy when the lesion showed growth 15 years after presentation. The patient subsequently developed recurrent hyphema, intraocular pressure up to 55 mmHg, and glaucomatous optic neuropathy. He eventually underwent iodine-125 brachytherapy resulting in tumor regression and improvement of intraocular pressure. Conclusion: Untreated iris melanoma can develop complications such as recurrent hyphema and glaucoma with irreversible optic nerve damage. Treatment of slow-growing iris melanoma must be considered to prevent complications.