Uveal melanoma is the most commonly diagnosed primary intraocular malignancy in adults. The
majority affect the choroid and to a lower extent the ciliary body and iris. It occurs more in fairly
pigmented people and with patients who have ocular melanosis. Most of these tumors are
asymptomatic at the time of detection and being discovered on physical examination. Patients
usually complain of decrease in vision when symptomatic which is mainly caused by retinal
detachment or vitreous hemorrhage. Eye exam exam may reveal an elevated, dome-shaped mass
under the retina, which may acquire a more mushroom shape. Pigmentation can range from
completely amelanotic (creamy white lesion) to darkly pigmented (gray black lesion). The
diagnosis is made clinically and by ultrasound.
Uveal melanoma can be classified according to size:
o Small: 1.0-2.4 mm height and/or 4.0-8.0 mm diameter.
o Medium: 2.5-10.0 mm height and/or 6 -16 mm diameter
o Large: >10.0 mm height and/or >16 mm diameter
Treatment of Uveal melanoma depends on the size of the tumor but it is usually a
multidisciplinary approach involving eye cancer specialists, general oncologists and radiation
oncologists. Plaque Brahytherapy is the treatment of choice for some small tumors and for all
medium sized tumors. Enucleation (Removal of the eye) is done for large size tumors. Patients
have to be followed up frequently for tumor size monitoring and for radiation toxicity. Also,
laboratory studies and Liver imaging must be done every 6