Foreign bodies of the iris as a rare differential diagnosis of malignant melanoma of the iris

Background: Lesions of the iris require a thorough examination to differentiate them from malignant melanoma because of the severe therapeutic consequences of the latter entity.

Methods: We observed two cases with a unilateral lesion on the iris, both suspicious of malignant melanoma of the iris. Ophthalmological, echographic and ultrasound biomicroscopic examinations were done.

Results: The cases of a 66-year-old man with a metallic foreign body and a 37-year-old man with a foreign body, both located on the iris, are presented.

Conclusions: In both patients an unclear lesion of the iris, suspicious of a malignant melanoma of the iris, turned out to be a foreign body after ophthalmoscopic examination. Both echography and ultrasound biomicroscopy were carried out and proved to be useful to confirm the diagnosis. No ocular inflammations, siderosis or secondary glaucoma occurred in the described cases. Observation of dormant foreign bodies is sufficient.