We report the case of a 31-year-old patient who presented with unilateral acute loss of vision, severe headache, and symptoms of an acute angle-closure glaucoma. Surprisingly, a prepapillary uveal melanoma was the underlying reason; that is, a masquerade syndrome was seen. Enucleation and histopathological investigation of that eye were performed within 3 days after first presentation. Acute angle-closure glaucoma as the initial presentation of uveal melanoma is rare. Nevertheless, clinicians should be aware that patients with refractory unilateral angle-closure glaucoma and asymmetrically opaque media may harbor an occult uveal melanoma.
