A case of small cell lung carcinoma with iris metastasis was treated with external beam radiotherapy with initial resolution of the lesions. The metastases then recurred, as depicted and the patient died from metastatic disease shortly thereafter.

A 35-year-old man complains of shadows in temporal side of his right eye for the last 4 months. A ultrasound biomicroscopy confirms the cystic nature of the mass.

Primary acquired melanosis (PAM)/conjunctival melanocytic intraepithelial neoplasia (C‑MIN). A, Mild PAM, involving 1 clock-hour of conjunctiva; unlikely to harbor atypia and may be observed. B, Histology of PAM (C-MIN) without atypia. H&E stain (top) shows melanocytic proli…

Pigmented OSSN show hyperplastic and hyperchromatic cells, dyskeratosis, keratin pearls, loss of cellular cohesion, and atypical mitotic figures. In pigmented OSSN, the pigmentation owing to abnormal proliferation of melanocytes in the lesions are noted.

B-scan ultrasonographic findings demonstrate a dome-shaped retinal lesion with characteristic scattered calcifications within the tumor (arrows).

Leukemic infiltration of the optic nerve, an ophthalmic emergency.

Retinal capillary hemangioblastoma (RCH), clinical photographs. Dilated, tortuous retinal feeder artery and draining vein emanate from the optic nerve head (A), leading to the red to orange peripheral retinal tumor (B). An optic nerve head hemangioblastoma causes traction in…

A, Clinical photograph shows a large, spherical vitreous seed (arrow) in retinoblastoma. B, OCT findings in a child with advanced retinoblastoma demonstrated an intact fovea, a dusting of small hyperreflective seeds on the retinal surface, and a hollow reflective cystic stru…

Caruncle keratoacanthoma is a rapidly growing epithelial proliferation.

Conjunctival pyogenic granuloma is a common benign vascular proliferation, appearing as smooth, red-purple, sessile or pedunculated lesions.

(A) Straphylococcus epidermidis endophthalmitis in a 86-year-old diabetic man 1 week after small-incision phacoemulsification with posterior chamber intraocular lens implantation. Visual acuity in hand motions at 1 ft. (B) About 5 months later and after pars plana vitrectomy…

Multimodal imaging of choroidal nevi. A, B, Color fundus photographs document the tumor borders and surface appearance of 2 thin choroidal nevi. C, Fundus autofluorescence (FAF) reveals minimal RPE disturbance in the area of the choroidal lesion. D, FAF shows decreased autof…

Malignant transformation of choroidal nevus to melanoma. A, Small choroidal nevus. B, After an observation period of 13 months, the nevus has expanded its borders and acquired surface lipofuscin. C, A different patient with a small peripapillary choroidal nevus. D, The nevu…

Differential diagnosis of iris melanoma. A, A pigment epithelial cyst (asterisk) can bow the iris forward focally. The cyst is visible after dilation. B, Multiple Lisch nodules in neurofibromatosis. Lisch nodules are melanocytic hamartomas that are typically tan to golden br…

Intraoperative localization of melanoma for treatment purposes. A, Transillumination of the eye reveals a shadow at the site of a choroidal melanoma. This technique may be used to mark the tumor base to ensure accurate placement of a radioactive plaque. B, B-scan ultrasonogr…

Benign iris melanocytic lesions, clinical appearance. A, Iris freckles are flat and often multiple. B–D, Iris nevi have a variable appearance and may be flat (B, C) or nodular (D). They may cause ectropion uveae (B). C–H, The slit-lamp (C, D), gonioscopic (E, F), and ultraso…

Optic nerve coloboma and pit. A, Fundus photograph of the right eye shows a colobomatous defect in the inferonasal optic nerve (arrow). B, Photomicrograph shows gliotic, disorganized retina (asterisk) that prolapses into the optic nerve head defect, which is lined by excavat…

Solitary fibrous tumor (hemangiopericytoma-like). A, Photomicrograph demonstrates a cellular tumor with a characteristic slitlike and branching vascular (staghorn) pattern. B, Photomicrograph demonstrates closely packed cells with oval to spindle-shaped vesicular nuclei.

Fibrous dysplasia. The bony trabeculae are often C-shaped, composed of immature woven bone, and surrounded by a fibrous stroma.

Immunoglobulin G4–related disease (IgG4-RD). A, CT image from a 67-year-old woman who presented with a 3-year history of an enlarging painless mass of the right lacrimal gland fossa, which was identified on CT as a homogeneously enhancing, circumscribed mass diffusely involv…

Neurilemoma (schwannoma). A, The Antoni A pattern. Spindle cell nuclei are arranged in linear palisades. B, Palisading of nuclei may form a Verocay body (asterisks). C, The Antoni B pattern consists of a loosely arranged, mucoid stroma and represents degeneration within the…

Sarcoidosis. A, Chorioretinitis in the fundus. B, Optical coherence tomography of the unaffected eye (top) and the eye with chorioretinitis (bottom) demonstrating thickening of the choroid in the eye with inflammation. C, Biopsy of a sarcoid nodule showing epithelioid his…

Choroidal osteoma. This choristomatous lesion is composed of compact bone (asterisk) and intratrabecular connective tissue.

Irritated seborrheic keratosis (also known as inverted follicular keratosis). A, Low-magnification photomicrograph shows a papillary epidermal proliferation with hyperkeratosis on the surface. Clinically, this lesion appeared as a cutaneous horn. B, High-magnification photom…

Aniridia, with a rudimentary iris present (visible near the limbus in this photograph). Cataract is also present.