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A 70-year-old man with aqueous-deficient dry eye presented for regular examination.
Diffuse illumination slit-lamp imaging revealed an abnormal dark lesion in the nasal-inferior
iris of his left eye (Fig A). The temporal view of the nasal-inferior cornea revealed a delle (a localized saucer-shaped
corneal thinning due to dehydration). Light passing through the concave lens caused
by the delle was diffused, resulting in a dark lesion on the iris underneath (Fig
B; right). The nasal view to avoid the optical artifact by the delle demonstrated no
dark lesion (Fig B; left), which was confirmed by cross-sectional anterior-segment OCT imaging (Fig
C). (Magnified version of Fig A-C is available online at www.aaojournal.org).
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