Peer through this pupil

This is a ciliary body melanoma of the left eye in a man in his 60s (fig 1). The patient presented to his GP with gradual deterioration of vision in the eye over the past four weeks and red flag symptoms of photopsia and loss of the inner field of vision in that eye. On examination, light was reflected off a mass in the lateral part of the left pupil. Differential diagnoses include retinal detachment and peripheral exudative haemorrhagic chorioretinopathy. Around 10% of uveal melanomas arise from the ciliary body1 and they have a high metastatic potential.2bmj;382/jul13_6/e075154/F1F1f1Fig 1
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