[Acute glaucoma: first manifestation of malignant melanoma of the choroid]

Most malignant melanomas of the choroid are discovered during a routine examination of the fundus or following visual symptoms. More rarely, increased intraocular pressure or acute glaucoma represent the first signs of intraocular malignant melanoma. A 66-year-old female presented with an unilateral acute closed angle glaucoma associated with rubeosis iridis and total retinal detachment. Using ultrasonography, a choroidal neoplasm was diagnosed. Histopathologic examination of the enucleated globe confirmed the diagnosis of a necrotic malignant melanoma of the choroid with subretinal hemorrhage. Every blind eye with opaque media requires ultrasonographic and, if enucleated, histopathologic examination.