Ciliary Body Nevus with Episcleral Extension in a 91-Year-old Patient

Abstract

A 91-year-old White woman was referred to the Wills Eye Hospital Ocular Oncology Service for evaluation of a pigmented scleral lesion right eye (OD). Per patient history, the lesion was stable for 25 years. Slit-lamp examination showed well-circumscribed episcleral pigmentation OD measuring 3.0 mm in diameter (A). Anterior-segment OCT revealed an underlying ciliary body mass with intrascleral invasion (B, white arrow), measuring 5.6 mm in diameter on ultrasound biomicroscopy and with minor extrascleral component (C, yellow arrow). A diagnosis of transcleral ciliary body nevus with episcleral extension was made. Observation was recommended. Extrascleral extension is a serious feature of ciliary body melanoma, but the remarkable chronicity of this lesion over 25 years was more suggestive of a benign entity (Magnified version of Figure A-C is available online at www.aaojournal.org).