Conjunctival melanoma is a rare but potentially lethal cancer arising from pigment cells on the eye surface. It can develop from a pre-existing naevus or primary acquired melanosis.
Presentation and risks
Early recognition is vital for better outcomes.
- Pigmented or occasionally non-pigmented raised lesion on the bulbar or palpebral conjunctiva
- Possible feeder vessels, growth, or changes in colour
- Risk of local recurrence, scleral invasion, and distant metastasis
- Association with fair skin and UV exposure in some cases
Treatment
Management aims for complete local control while preserving the eye where possible.
- Wide local excision with “no-touch” technique and cryotherapy
- Topical chemotherapy, brachytherapy, or radiotherapy for residual disease
- Regular systemic staging and oncologic follow-up
- Long-term surveillance for recurrence in both eyes
