{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:40:16Z","timestamp":1756374016990,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,12]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>We present a case of unilateral, secondary open-angle glaucoma due to an underlying diffuse iris melanoma. The patient was referred by his ophthalmologist with uncontrolled, elevated intraocular pressure in the left eye. He had been treated for asymmetric open-angle glaucoma for over a year prior to referral. Slit-lamp examination and gonioscopy showed prominent asymmetric hyperpigmentation of the left iris, with a nodular pigmented mass in the inferior angle. A biopsy of the lesion showed features consistent with a pigmented iris melanoma. A full systemic work-up was performed, which ruled out any secondary lesions. The patient opted for enucleation over proton beam therapy for treatment. This case highlights the importance of considering secondary glaucoma in patients with unilateral or highly asymmetric glaucoma, and gonioscopy plays an important role in the clinical assessment. Secondary glaucoma due to intraocular melanoma is a rare entity, but has important implications for affected patients.<\/jats:p>","DOI":"10.1136\/bcr-2023-258869","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T09:35:15Z","timestamp":1738575315000},"page":"e258869","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary open-angle glaucoma as an initial presentation of diffuse iris melanoma"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3389-8999","authenticated-orcid":false,"given":"Emiel","family":"Matthys","sequence":"first","affiliation":[{"name":"Ophthalmology, UZ Leuven, Leuven, Flanders, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Missotten","sequence":"additional","affiliation":[{"name":"Ophthalmology, UZ Leuven, Leuven, Flanders, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Van Ginderdeuren","sequence":"additional","affiliation":[{"name":"Ophthalmology, UZ Leuven, Leuven, Flanders, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Lemmens","sequence":"additional","affiliation":[{"name":"Ophthalmology, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"2025082802251354000_18.2.e258869.1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.clindermatol.2023.10.009","article-title":"Iris melanoma: Review of clinical features, risks, management, and outcomes","volume":"42","author":"Cherkas","year":"2024","journal-title":"Clin Dermatol"},{"key":"2025082802251354000_18.2.e258869.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(02)01104-1"},{"key":"2025082802251354000_18.2.e258869.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(00)00449-8"},{"key":"2025082802251354000_18.2.e258869.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.83.2.194"},{"key":"2025082802251354000_18.2.e258869.5","doi-asserted-by":"crossref","first-page":"8766","DOI":"10.3390\/app10248766","article-title":"Iris Melanoma: Management and Prognosis","volume":"10","author":"Russo","year":"2020","journal-title":"Appl Sci (Basel)"},{"key":"2025082802251354000_18.2.e258869.6","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1038\/modpathol.2014.43","article-title":"Clinical significance of immunohistochemistry for detection of BAP1 mutations in uveal melanoma","volume":"27","author":"Koopmans","year":"2014","journal-title":"Mod Pathol"},{"key":"2025082802251354000_18.2.e258869.7","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1159\/000512012","article-title":"Locally Invasive Diffuse Iris Ring Melanoma Presenting as Unilateral Severe Glaucoma: Case Report and Review of Molecular Genetics","volume":"14","author":"Naguib","year":"2021","journal-title":"Case Rep Oncol"},{"key":"2025082802251354000_18.2.e258869.8","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.ogla.2022.08.002","article-title":"Incidence and Risk Factors for Secondary Glaucoma in Eyes with Uveal Melanoma","volume":"6","author":"Stadigh","year":"2023","journal-title":"Ophthalmol Glaucoma"},{"key":"2025082802251354000_18.2.e258869.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.85.6.666"},{"key":"2025082802251354000_18.2.e258869.10","doi-asserted-by":"crossref","unstructured":"Tong MG , Ozment RR , Chen TC . Ocular tumors and glaucoma. In: Albert and Jakobiec\u2019s Principles and Practice of Ophthalmology. Springer International Publishing, 2022: 2269\u201386.","DOI":"10.1007\/978-3-030-42634-7_174"},{"key":"2025082802251354000_18.2.e258869.11","unstructured":"Albeiruti E . Glaucoma secondary to iris melanoma. Glaucoma Today; 2021."},{"key":"2025082802251354000_18.2.e258869.12","first-page":"8163","article-title":"Secondary glaucoma as initial manifestation of ring melanoma: a case report and review of literature","volume":"7","author":"Zhao","year":"2014","journal-title":"Int J Clin Exp Pathol"},{"key":"2025082802251354000_18.2.e258869.13","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1159\/000496847","article-title":"Diffuse Iris Melanoma: Conservative Treatment with Proton Beam Therapy after Limbal Stem Cell Preservation or Enucleation?","volume":"5","author":"Leblanc","year":"2019","journal-title":"Ocul Oncol Pathol"},{"key":"2025082802251354000_18.2.e258869.14","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2011-301420"},{"key":"2025082802251354000_18.2.e258869.15","first-page":"339","article-title":"Diffuse iris melanoma: Report of a case with review of the literature","volume":"1","author":"Skalicky","year":"2007","journal-title":"Clin Ophthalmol"},{"key":"2025082802251354000_18.2.e258869.16","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1097\/IJG.0b013e31825c0fb7","article-title":"Red laser cyclophotocoagulation in the treatment of secondary glaucoma in eyes with uveal melanoma","volume":"23","author":"Piirtola","year":"2014","journal-title":"J Glaucoma"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258869","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:25:22Z","timestamp":1756373122000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,3]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/bcr-2023-258869"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258869","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}