A 44-year-old otherwise healthy female presents with 1 year of blurry vision in the right eye and headaches. The patient reported being a daily smoker and having a strong family history of cancer. The patient’s uncorrected visual acuity was 20/20 OU, with IOP of 39 OD and 21 OS. Anterior segment examination revealed iris heterochromia with increased pigmentation of the right iris. A vascular iris mass was noted superiorly from 10 to 2 o’ clock with significant pigmentation of the inferior angle on gonioscopy. The ocular examination was otherwise unremarkable. Ultrasound biomicroscopy demonstrated a 2.78mm mass with extension posterior to the iris and possible ciliary body involvement. No additional ocular lesions were identified on ocular ultrasound. The patient was diagnosed with iris melanoma, complicated by secondary glaucoma. The patient was treated with plaque radiation therapy due to the anterior location of the iris mass and topical aqueous suppressants.