Posterior Segment
Choroidal Melanoma
Also known as: choroidal melanoma, ocular melanoma, uveal melanoma, pigmented choroidal mass, suspicious choroidal lesion, orange pigment, subretinal fluid
Filed as: Soon
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Choroidal melanoma is a potentially life-threatening intraocular malignancy. Optometry role is detection of suspicious choroidal mass features, careful documentation, and urgent referral to ocular oncology or retinal specialist pathways. Do not reassure a suspicious lesion as a naevus without risk assessment.
Recognition
Symptoms: what patients report
- May be asymptomatic and found incidentally.
- Blur, visual field defect, flashes, floaters, or distortion may occur depending on location and associated fluid.
- Symptoms do not reliably indicate malignancy risk.
Signs: what the examination shows
- Elevated pigmented choroidal mass.
- Orange pigment, subretinal fluid, or associated retinal detachment may be present.
- Document lesion size, thickness if available, margins, symptoms, and proximity to optic disc or fovea.
What OptoGuide™ covers for choroidal melanoma
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting
Sources
- Choroidal and Ciliary Body Melanoma — EyeWiki
- The Differential Diagnosis of Posterior Uveal Melanoma. Shields JA, Augsburger JJ, Brown GC, Stephens RF. Ophthalmology. 1980;87(6):518-22.
- Choroidal Melanoma: Clinical Features, Classification, and Top 10 Pseudomelanomas. Shields CL, Manalac J, Das C, Ferguson K, Shields JA. Current Opinion in Ophthalmology. 2014;25(3):177-85.
- Peripheral Exudative Hemorrhagic Chorioretinopathy Simulating Choroidal Melanoma in 173 Eyes. Shields CL, Salazar PF, Mashayekhi A, Shields JA. Ophthalmology. 2009;116(3):529-35.
- Centre for Eye Health — Chair-side Reference: Pigmented Posterior Lesions
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.