Ultrasound Biomicroscopy in the Diagnosis and Management of Iris and Ciliary Body Tumors: A Comprehensive Review.

Background: Although uncommon, tumors of the iris and ciliary body present significant diagnostic challenges because of their variable appearance and overlap between benign and malignant features and the difficulty of directly visualizing lesions located in the posterior iris or ciliary body using conventional methods. Summary: The advent of high-resolution anterior segment imaging, particularly ultrasound biomicroscopy (UBM), has greatly enhanced the ability of clinicians to evaluate these lesions in vivo. This review synthesizes current evidence on the utility of UBM in the diagnosis, classification, and management of both iris and ciliary body tumors. The emphasis is placed on differentiating melanotic from amelanotic lesions, recognizing imaging characteristics that suggest malignancy and comparing UBM with other anterior segment modalities, such as gonioscopy and anterior segment optical coherence tomography. This study provides a detailed discussion of tumor morphology, growth patterns, and secondary complications, supplemented by illustrative examples from clinical practice. Key Message: UBM serves as a noninvasive, reproducible, and dynamic view of lesions located deep within the anterior segment, particularly those obscured from direct examination, thereby guiding both diagnosis and longitudinal management.