Introduction

• Cause:primary (eg melanoma) vs secondary (eg lymphoma).
• Signs: change in appearance of eye, pain, intraocular hemorrhage, glaucoma, uveitis, retinal detachment.
• Diagnosis: ophthalmic examination, ocular ultrasound, cytology, histopathology.
• Treatment: enucleation/exenteration, chemotherapy, tumor excision.
• Prognosis: depends on histopathological diagnosis.

Pathogenesis

Etiology

• Primary:
  • Melanomas (most common).
  • Ciliary body (iridociliary) adenoma and adenocarcinoma   .
  • Medulloepithelioma.
  • Spindle cell tumor.
• Secondary:
  • Lymphoma Lymphoma (most common).
  • Hemangiosarcoma Hemangiosarcoma.
  • Cutaneous and oral melanoma Skin: melanoma.

Pathophysiology

• Melanomas Skin: melanoma :
  • Melanocytoma:
    • Benign anterior uveal melanoma  :
      • Metastasis <5%.
    • Limbal melanoma.
    • Choroidal melanoma  .
  • Malignant melanoma:
    • May arise within eye and metastasize to the eye from more distant sites.
    • Primary malignant melanomas:
      • Metastasis ~25%.
• Iridociliary epithelial tumors:
  • Adenomas and adenocarcinomas.
  • Both tend to behave in benign way within eye.
• Medulloepitheliomas:
  • Arise from inner layer of optic cup.
  • Congenital.
  • Usually clinicall benign.
• Lymphomas Lymphoma :
  • Usually as a result of metastasis to eye, rarely seen as primary intraocular tumor.
  • Systemic lymphoma may also involve the eye in ~35% cases .
  • Often bilateral.

Timecourse

• Melanomas and iridociliary tumors tend to be slow growing over months/years.
• Spindle cell tumors and lymphoma are aggressive (weeks).

Diagnosis

Treatment

Outcomes