Objective: To report a case where iris metastasis was the presenting sign of hitherto undiagnosed non-small cell lung carcinoma. The diagnostic approach and patient management are discussed.

Methods: A 51-year-old man presented with pain due to an iris mass and neovascular glaucoma.

Results: Systemic evaluation subsequently led to the diagnosis of non-small cell lung carcinoma and the iris mass was considered metastatic. The patient refused any systemic therapy and accepted only intervention for ocular pain relief. Ranibizumab was administered intravitreally and resulted in subsidence of iris mass and new vessels and pain relief, which enhanced the patient's quality of life.

Conclusions: This is the first known report where intravitreal injection of ranibizumab was used as palliative treatment for refractory neovascular glaucoma due to iris metastasis.