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Uveal and conjunctival melanomas

Evangelos S Gragoudas, MD
Anne Marie Lane, MPH
Helen A Shih, MD
Richard D Carvajal, MD
Section Editors
Michael B Atkins, MD
Jonathan Trobe, MD
Russell S Berman, MD
Deputy Editor
Michael E Ross, MD


Approximately 95 percent of melanomas around the eye are found in the uvea, while the remainder arise in the conjunctiva. There are significant differences between uveal melanomas (including iris, ciliary body, and choroid) and melanomas arising at other sites, including the conjunctiva. Both uveal and conjunctival melanoma are discussed in this topic.

Issues related to cutaneous and mucosal melanomas are discussed separately. (See appropriate topic reviews.)


Uveal melanomas arise from melanocytes in the uvea. These melanomas have significant differences from cutaneous melanomas that guide their management [1].

Uveal melanomas can develop in any part of the uveal tract, including the iris, ciliary body, and choroid (figure 1). Iris melanomas are less common than choroidal melanomas (approximately 5 versus more than 80 percent of cases). Iris melanomas are also associated with a better prognosis than ciliochoroidal tumors (10-year survival approximately 95 versus 77 percent). Because of the less aggressive nature of iris melanomas, these tumors are usually managed conservatively (ie, close monitoring of the tumor). Fast-growing tumors may be excised. This topic will emphasize the management of uveal melanoma as it pertains to choroidal and ciliary body melanoma, the more common and life-threatening forms of the disease.

Clinical presentation and diagnosis — Intraocular tumors generally present with visual symptoms or are detected as an incidental finding. The diagnosis of uveal melanoma is based upon funduscopic examination by an experienced clinician, which is followed by further characterization with specialized noninvasive testing techniques, such as ultrasound and fluorescein angiography. Biopsy is generally not indicated but is done in selected cases, mostly ciliary body tumors. Biopsy historically was generally not indicated. However, biopsy provides information about the molecular characteristics of the tumor, which can provide important information about the risk of recurrence, although it will not affect the initial management. (See "The molecular biology of melanoma", section on 'Uveal melanomas'.)

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Literature review current through: Nov 2017. | This topic last updated: Apr 27, 2017.
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