Iris cavernous hemangioma in a patient with recurrent hyphema.

A 41-year-old woman presented with a hyphema in her right eye. Clinical examination revealed a vascular lesion of the iris that had enlarged over a 6-month period. The patient had no other evidence of ocular or cutaneous vascular malformations. Subsequently she experienced recurrent episodes of spontaneous hyphema, and there was objective evidence of growth of the lesion. Consequently, the lesion was excised by means of a sector iridectomy. Histopathological examination showed several large vascular compartments separated by thin, fibrous septa and lined by endothelium, consistent with a cavernous hemangioma. A benign iris melanocytic lesion was identified adjacent to the cavernous hemangioma. The intraocular pressure in the affected eye remained normal after the lesion was removed. After 6 months of follow-up no new hyphemas had developed. Iris cavernous hemangioma should be added to the differential diagnosis of recurrent hyphema.