49 year-old referred for trabeculectomy with the diagnosis of pigmentary glaucoma. He had a history of elevated IOP in the right eye for 4 years. He had had pressures as high as 47 mmHg. At present he was on four medications and had undergone a trabeculoplasty. On examination he had an IOP of 38 mmHg and total cupping of the optic nerve with a 5-degree visual field. The patient underwent enucleation, which confirmed the diagnosis of diffuse melanoma.