Isolated Recurrence of Diffuse Large B-Cell Lymphoma Predominantly in the Iris and Ciliary Body

<b>Purpose:</b> To describe a single case of systemic lymphoma recurring in the iris and ciliary body. <b>Methods:</b> A retrospective case review was performed. <b>Results:</b> A 75-year-old woman presented to the retina service with an iris mass in the left eye. Her medical history was significant for previous systemic diffuse large B-cell lymphoma treated with systemic chemotherapy. Aqueous sampling was significant for recurrence of the disease. Local therapy with intravitreal (IVT) methotrexate was initiated. Although there was initial improvement, an increased interval between injections led to disease recurrence. External beam radiation to the left eye was then applied, leading to a complete clinical remission. <b>Conclusions:</b> Systemic lymphoma presenting in the iris is a rare manifestation that should be considered on the differential for an amelanotic iris lesion. Although monotherapy with IVT methotrexate did not control the ocular disease in this patient, subsequent external beam radiation resulted in complete clinical remission.