When ocular melanoma is suspected, speed and coordination matter because management decisions are time-sensitive and depend on subspecialist imaging interpretation and treatment planning. ²
Modern ocular oncology pathways aim to achieve:
- Rapid diagnostic confirmation
- Appropriate local treatment (for example plaque radiotherapy where indicated) ¹
- Long-term systemic surveillance and shared follow-up
Treatment selection depends on tumour size, location, and risk profile. Plaque radiotherapy has strong evidence for tumour control in many settings, including challenging locations, while preserving the eye in a large proportion of patients. ¹ Because metastasis risk is related to tumour biology and stage, structured follow-up remains important even after local control is achieved. ³
A “linked care” model reduces delay and duplication: local imaging and symptom triage, fast oncology escalation when thresholds are crossed, then shared monitoring once the diagnosis and plan are established. ²
References
- Sagoo MS, Shields CL, Kaliki S, Shields JA. Plaque radiotherapy for juxtapapillary choroidal melanoma: tumor control and visual outcomes in 650 consecutive cases. Archives of Ophthalmology. 2012;130(3):264-271. doi:10.1001/archophthalmol.2011.1730. PMID: 22411697.
- Shields CL, Demirci H, Materin MA, Marr BP, Mashayekhi A, Shields JA. Clinical factors in the identification of small choroidal melanoma. Canadian Journal of Ophthalmology. 2004;39(4):351-357. doi:10.1016/S0008-4182(04)80005-X. PMID: 15327099.
- Shields CL, Shields JA. Melanoma of the eye: revealing hidden secrets, one at a time. Clinical and Experimental Ophthalmology. 2015;43(8):734-749. doi:10.1111/ceo.12547. PMID: 26213399.
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