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Background: The differential diagnosis of melanocytic iris tumours is very difficult. Signs of malignancy such as pupil distortion, ectropium uveae, secondary cataract and secondary glaucoma can also occur with benign iris nevi. However, spontaneous hyphemata occur in 6.9% to 13% of melanomas, while anterior chamber hemorrhages are extremely rare with nevi., Patient and Method: A 69 year old man with a pigmented iris tumor of the right eye strictly refused surgical treatment. Therefore the tumor was followed clinically over 32 years. Over this period the tumor showed a very slow increase in size. Twenty-seven years after the initial presentation for the first time a spontaneous anterior chamber hemorrhage occurred. In the following period, the patient experienced recurrent hyphemata at last approximately every two months. An excisional biopsy consisting of a sector-iridectomy and localized excision of Descemet's membrane was performed. Histologically, the tumor was classified as a melanoma of the iris., Conclusion: A careful documentation cannot be overemphasized in the follow up of patients with pigmented iris lesions. In case of spontaneous hyphema histological evaluation is required even in the absence of evident tumor growth.

Case report on a child with acute lymphogenous leukemia. Although there was constant hematological remission she developed an isolated leukemic iritis and secondary glaucoma. The clinical picture showed a characteristic stratification of the hyphema. After the patient had remained seated for a prolonged period of time the leukemic cells settled above the erythrocytes, forming a so-called pseudohypopyon, which diagnostically important. Cytologic examination after anterior chamber paracentesis is indispensable in order to establish the etiology of the disease. Isolated leukemic iritis may be the first sign of a relapse and therefore indicate a need to reinstitute induction therapy.

Among 81 eyes enucleated after severe trauma, two eyes showed a peculiar granulomatous reaction around a bloodcoagulum. The bloodcoagulum is surrounded by a granulomatous infiltration of epithelioid and giant cells containing haemotoidin; peripheral to this there are haemosiderin containing makrophages and granulation and scartissue as well as an unspecific lymphocytic infiltration of uvea and retina. There are also signs of persistent hypotony. The similarity to endophthalmitis phacoanaphylactica is stressed. It is postulated that the endophthalmitis haemo-granulomatosa is analogous to sympathetic uveitis, and phacoanaphylactica endophthalmitis represents a peculiar reaction to autologous intraocular tissue, which may occur in unspecific types of reaction, makrophagocytic reactions and as a granulomatous type. The differentialdiagnosis is discussed as well as possible clinical implications.