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Ultrasound biomicroscopy in the diagnosis of a foreign body simulating iris melanoma

Editor,—Several lesions of the iris can clinically resemble melanoma.1 2 Failure to recognise a simulating condition could lead to misdirected therapy. The most common iris pseudomelanomas include primary iris cyst, iris naevus, essential iris atrophy, iris foreign body, peripheral anterior synechia, and iris metastasis.2 

An iris foreign body can occasionally pose a diagnostic challenge, especially in the absence of a history of ocular trauma. We present a case of an iris foreign body that resembled a melanoma, in which ultrasound biomicroscopy (UBM) was instrumental in the diagnosis.

### CASE REPORT

In June 1999, a 70 year old man was found on routine examination to have a brown lesion in the inferior part of his left iris. Two months later the lesion showed a possible increase in size, prompting a referral to the oncology service of the Wills Eye Hospital to rule out iris melanoma.

His visual acuity was 20/20 in both eyes and the intraocular pressures were normal. There was no …