Congenital Iris Nevus

January 1, 2005
Robert P. Blereau, MD
Robert P. Blereau, MD

Brown pigmentation of the medial 60% of the left iris was noted in a 40-yearoldwoman. The remainder of the iris was blue, as was the entire right iris.She stated that she had a “spot” of brown in the left iris at birth. The pigmentedarea had gradually enlarged until puberty and had not changedsince then. Her vision was normal.

Brown pigmentation of the medial 60% of the left iris was noted in a 40-yearoldwoman. The remainder of the iris was blue, as was the entire right iris.She stated that she had a "spot" of brown in the left iris at birth. The pigmentedarea had gradually enlarged until puberty and had not changedsince then. Her vision was normal.Although iris nevi are common, they are usually not as large as this patient's.These nevi are typically unilateral.Other causes of hyperchromatism of the iris include oculodermal melanocytosis(nevus of Ota)--a rare congenital condition with associated ipsilateralskin hyperpigmentation. Iris hyperpigmentation is common inpatients with hemosiderosis and is occasionally seen in those with Sturge-Weber syndrome. Use of latanoprost, bimatoprost, or travoprost for treatmentof glaucoma may increase iris pigmentation.1Iris melanoma is a rare, slow-growing malignancy that usually presentsin the fifth decade of life and is more frequent in persons with nevus of Ota.Metastatic carcinoma of the iris most commonly originates from the breastand bronchus and is frequently bilateral. Occasionally, iris nevi may giverise to malignant melanoma.2 Therefore, yearly ophthalmic examinationsare recommended.

References:

REFERENCES:
1.

Kanski JJ, Nischal KK. Ophthalmology: Clinical Signs and Differential Diagnosis. London: Mosby; 1999:189, 206, 208.

2.

Tasman W, Jaeger EA. The Wills Eye Hospital Atlas of Clinical Ophthalmology. 2nd ed. Philadelphia:Lippincott-Raven; 2001:248.