Intrastromal Amelanotic Iris Nevus

This 53 year-old white male went to his optometrist complaining of decreased visual acuity in the right eye and was found to have a hyphema and an elevated intraocular pressure to 32 mmHg. When we saw him he had an amelanotic mass as seen here. His visual acuity was equal and normal in both eyes and his intraocular pressures were 16 mmHg OD and 17 mmHg OS. On echography this lesion was 1.9 mm thick and appeared to extend deep into the angle but not into the ciliary body. The lesion was vascular. It was recommended to this patient that he consider excision of this lesion but he refused any surgical management. 26 months later he returned because the lesion was bleeding intermittently. The lesion was resected and was found to be an intrastromal amelanotic iris nevus. Eight weeks after his surgery he had 20/25 vision and an intraocular pressure of 14 mmHg.