Angle closure glaucoma as initial manifestation of melanocytoma of the optic disc

A 44-year-old man had progressive visual loss and pain due to angle-closure glaucoma associated with a papillary pigmented lesion. The eye was enucleated because of intractable pain and the suspicion of a malignant tumor. Histologic and electron microscopic examination of the enucleated eye revealed a partially necrotic melanocytoma of the optic nerve. There was histologic evidence of vaso-occlusive disease within the optic nerve that resulted in ischemic necrosis of the tumor, hypoxic retinopathy and neovascular glaucoma. This report emphasizes that significant complications may occur in otherwise typical intraocular nevi.