Iris melanoma: pathology, prognosis and surgical intervention

A case of an iris melanoma in a 58-year-old woman is described. The clinical and pathological findings are discussed, highlighting the correlations between histopathology and prognosis for iris melanoma, which differ markedly from choroidal melanoma. The mixed cellular pathology of this iris melanoma (containing both spindle B cells and epithelioid cells) carries a higher metastatic rate than tumours composed exclusively of either. This contrasts with choroidal melanoma, where the presence of epithelioid cells is the strongest pathological marker for a poor prognosis. The ocular outcome that can be achieved with local surgical excision of a well-delineated iris melanoma that does not involve the angle is discussed.