Recently, an otherwise healthy 25-year-old White woman presented to our office for what was believed to be a routine eye examination. She had never needed corrective lenses and had not been seen by an eye care professional in more than 5 years.
The patient’s chief complaint was a gradual blurring of vision in only her left eye over the past 6 months. Upon examination it was immediately evident that something was abnormal. Her UCVA was 20/20 OD and hand motions OS. Retinoscopy showed a clear red reflex in the right eye and no reflex in the left eye. Confrontation visual fields were also significantly restricted in the patient’s left eye. During the slit-lamp examination, a large mass was observed extending from underneath the nasal iris surface into the pupillary margin (Main Figure). B-scan ultrasonography in the office confirmed a mass approximately 8 mm in size extending from near the ciliary body base (Inset).
Uveal melanoma is the most common primary intraocular malignancy in White adults. Ciliary body melanomas are rarely seen and have the worst prognosis of all intraocular melanomas.1
Suspecting that this patient has some form of uveal melanoma, we referred her to an ocular oncologist for additional testing, and we await her diagnosis and likely prognosis. This patient’s case highlights the importance of yearly eye exams for early detection and early treatment of uveal melanoma and other ocular malignancies.
- 1. Costache M, Patrascu OM, Adrian D, et al. Ciliary body melanoma – a particularly rare type of ocular tumor. Case report and general considerations. Maedica (Buchar). 2013;8(4):360-364.