An 83-year-old woman presented with accumulations of pigment in the anterior chamber of her right (Fig A) but not left eye (Fig B). Fundus examinations, gonioscopy, B-scan ultrasonography (Fig C), and ultrasound biomicroscopy failed to identify an intraocular tumor. An iris biopsy revealed a proliferation of melanocytes without atypia (Fig D), which were intensively immunoreactive for Melan A (Fig E). A diagnosis of unilateral diffuse uveal melanocytic proliferation was established. Later, the patient revealed she had a small cutaneous melanoma removed from her back 50 years prior. On radiological examinations, metastases were detected in her liver, lungs, and spine. The pigment gradually increased (Fig F) until the patient died due to metastatic cutaneous melanoma 16 months after presentation (Magnified version of Fig A-F is available online at www.aaojournal.org).