How are intraocular tumors diagnosed?

Updated: Jun 25, 2020
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Answer

Diagnosis is assisted by gonioscopy, indirect ophthalmoscopy, and ultrasonography. Clinical scenarios depend on tumor location. Hyperchromic heterochromia with glaucoma may help to diagnose ipsilateral iris melanoma, whereas anterior displacement of the iris-lens diaphragm may be present in ciliary body melanoma.

Iris melanoma can occur as either diffuse or well-circumscribed forms, with the former being less common and more malignant.

Ciliary body melanomas tend to be larger at presentation due to their obscure location and usual lack of visual symptoms. They may present as a ring melanoma, which completely encircles the ciliary body. Proportion of epithelioid cells is higher in ciliary body melanoma. Shields et al report that 50% of patients seen at Wills Eye Hospital with ciliary body melanoma died within 2 years due to metastases. [1]

Choroidal tumors associated with glaucoma typically have broken through the Bruch membrane and are mushroom shaped.


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