Benjamin A King1,2 Elizabeth U Rosenberger,1 Vanessa M Morales-Tirado,1,3 Matthew W Wilson1,2 1Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, College of Medicine, Memphis, TN, USA; 2Department of Surgery, St Jude Children’s Research Hospital, Memphis, TN, USA; 3Department of Microbiology, Immunology, and Biochemistry, University of Tennessee Health Science Center, College of Medicine, Memphis, TN, USA Purpose: To report the clinical features of uveal metastases in a geographic region associated with high tobacco use. Methods: Medical records from all patients diagnosed with uveal metastasis at a single tertiary referral center between 2000 and 2017 were retrospectively reviewed. The clinical features and the primary tumor site associated with each metastatic lesion were recorded. Results: Ninety-nine uveal metastatic tumors were identified in 85 eyes of 74 patients (34 males). Median age at diagnosis was 62 years. Median tumor diameter was 11.6 mm and median height was 3.1 mm. Carcinoma of the lung was the most common primary tumor occurring in 37 patients (50%) followed by breast in 16 patients (21%). Among females, metastatic lesions originated from the lung in 18 patients and from the breast in 16 patients. Median survival following intraocular metastasis was 9 months for patients with a primary lung malignancy and 36 months for patients with breast cancer (log-rank test, P=0.002).Conclusion: Intraocular metastasis is more frequently observed in patients with carcinomas of the lung rather than breast at our treatment center. Both regional and global changes in cancer epidemiology most likely account for the findings in this study.Keywords: iris, choroid, cancer, metastases, lung, breast, eye