An 85-year-old healthy White woman was assessed for extensive primary acquired melanosis involving the left bulbar conjunctiva (Fig A, B). She had no history of autoimmune disease or previous cutaneous melanoma. Her right eye showed no abnormalities. As the pigmentation had been present for at least 50 years, we opted to closely observe the patient, without any treatment. During the next 5 years, the area of pigmentation progressively decreased in area and degree of pigmentation (Fig C, D). No signs of disease relapse, skin changes, or malignancy occurred over the following 2 years. The ocular fundus remained unchanged throughout this time. Spontaneous resolution of melanosis is a rare event, sometimes triggered by infection or autoimmunity, none of which had knowingly occurred in this patient (Magnified version of Fig A-D is available online at www.aaojournal.org).

https://www.aaojournal.org/article/S0161-6420(21)00161-5/fulltext