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Last Month’s Blink

Iris Hemangioma

Written by Savannah Kumar, MD, Paul T. Finger, MD, Abhilasha Maheshwari, MD, Vincent P. Moscato, MD, and Abha Amin, MD. Photos by Dr. Finger. Dr. Kumar is at Zucker School of Medicine in Hempstead, New York; Dr. Amin is at New York Medical College, Valhalla; Drs. Finger and Maheshwari are at the New York Eye Cancer Center; and Dr. Moscato is at Crystal Run Healthcare in Middletown, New York.

A systematically healthy 42-year-old woman with no prior ocular history was referred to us for evaluation of spontaneous hyphema of the left eye. She had no associated trauma or Valsalva events, and the only notable finding on examina­tion was an enlarged iris blood vessel, running parallel to the ciliary body, seen on gonioscopy (Fig. 1).

Upon referral to the ocular oncologist, the patient’s VA was 20/12.5, and IOPs were normal. Slit-lamp and dilated fundus examination of the left eye revealed no visible source of bleeding (Fig. 2). High-frequency ultrasound imaging showed a solitary neuroepithelial iris cyst in the 6 o’clock position of the left eye with an associated slight angle narrowing. Iris fluorescein angiography revealed leakage along the pupillary margin, leading to a diagnosis of iris hemangiomas (Figs. 3 and 4). This rare condition has been reported to be the source of spontaneous hyphe­ma. The patient was managed with observation.

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