Choroidal naevus or melanoma may be easily missed if you were asked to examine with an direct ophthalmoscope especially if the lesion is only slightly pigmented. Remember to look for this if the optic disc, macula and retinal vessels are normal.
The lesion appears as an elevated, pigmented mass. There may be orange pigment (lipofuscin) on the tumour. Look for any retinal detachment around it. In melanoma treated with plaque, the surrounding area shows atrophy or surrounded by hard exudate (see the picture on the left).
- Rarely the patient may have ipsilateral facial hyperpigmentation due to naevus of Ota which is associated with increased risk of melanoma.
1. What treatment options are available for choroidal melanoma?