Early detection of uveal melanoma – a case report

Purpose:

This case report describes the accidental early detection of a small choroidal melanoma during a routine opto­metric examination. The following is a report of a rare case of choroidal melanoma, in a 58-year-old male Caucasian. He wanted to have glasses for computer work and complained of occasional flickering, when seeing in the morning after getting up.

Material and Methods:

The following optometric measurement methods were used: confrontation visual field test, extraocular muscle function test, cover test, retinoscopy (Heine Beta 200 Retinoscope), refraction, slit lamp examination (slit lamp Zeiss SL 120) with evaluation of the anterior eye, evaluation of the posterior eye (Heine Beta 200 Ophthalmoscope) and handheld fundus camera (Zeiss Visuscout 100).

Results:

On fundus examination of the left eye, a light pigmented retinal lesion with orange pigment and retinal elevation was seen temporally on the upper vascular arch. Due to the suspected diagnosis of choroidal melanoma, immediate contact was made with a local ophthalmology practice. This confirmed the suspicion and the patient was referred to the University Eye Clinic in Munich.

Conclusion:

Uveal melanoma is the most common intraocular malignancy and arises from melanocytes in the iris, ciliary body or choroid. Early diagnosis and local treatment are crucial, as survival correlates with primary tumor size. Approximately 50 percent of patients will develop metastatic disease with survival of 6 - 12 months after metastatic diagnosis. The University Eye Clinic Munich confirmed the diagnosis of choroidal melanoma. A robotic Cyberknife radiosurgery was performed.