Iris melanoma, clinical appearance. A, The lesion can be amelanotic and show intrinsic vascularity. B, Alternatively, it may be densely pigmented, hiding any blood vessels (note the ectropion uveae [arrows] at the lower pupillary margin). C, Diffuse iris melanomas disseminate in the anterior chamber and chamber angle. D, These melanomas may have a granular, tapioca pudding–like appearance. Anterior chamber angle involvement is associated with secondary glaucoma and risk of metastasis.