AN 11-YEAR-OLD asymptomatic white girl was seen for a pigmented conjunctival lesion of the left eye. The parents reported that the lesion had become noticeable 3 weeks earlier. Her ophthalmologic history was remarkable for infantile left dacryostenosis,which resolved spontaneously at 6 to 8 months of age, and mild myopia, corrected with lenses since age 10 years. On examination, a slightly elevated, movable, tan-yellow nodule with a deep brown area was observed on the bulbar conjunctiva near the inner canthus of the left eye (Figure 1). No other bulbar or palpebral pigmentation was noted. An excisional biopsy was performed. A 0.5 × 0.3 × 0.15-cm conjunctival specimen was white-yellow and contained a slightly eccentric dark brown pigmented lesion (Figure 2, Figure 3, and Figure 4).