Melanomalytic Glaucoma

A 46-year-old woman presented with pain and an intraocular pressure of 63 mmHg in the left eye 2 years after plaque brachytherapy for uveal melanoma. Examination revealed pigmented material in the anterior chamber (Fig 1), a choroidal mass (Fig 2), and marked pigmentation in an open trabecular meshwork with gonioscopy. Histopathology of this blind, painful eye confirmed the diagnosis of spindle B type uveal melanoma (Fig 3), with foci of necrosis and pigment laden macrophages (melanophages). Melanophages (black arrow) were deposited on the ciliary body (CB), iris (I) and in the trabecular meshwork (white arrow, Fig 4; C indicates cornea).