Intraocular melanoma most commonly arises from uveal melanocytes in adults. It is the most frequent primary intraocular malignancy in this group.
Clinical features
Many tumours are found incidentally, though symptoms can occur.
- Pigmented or amelanotic choroidal or ciliary body mass on examination
- Visual symptoms such as blur, field defects, or flashes and floaters
- Risk factors include light skin, light irides, and certain genetic changes
- Ultrasound and imaging help distinguish tumours from benign naevi
Management
Treatment balances tumour control with visual preservation.
- Plaque brachytherapy or proton beam radiotherapy for many medium-sized tumours
- Enucleation for large or painful eyes or when vision cannot be saved
- Systemic staging and liver surveillance because of metastatic risk
- Long-term ocular and oncological follow-up
