Treatment
Brachytherapy (internal radiotherapy) is the treatment of choice if tumour is less than 10 mm in elevation and other techniques include Transpupillary thermotherapy and external beam radiotherapy as well.
Enucleation is the final step alongside chemotherapy for metastasised tumours.
Malignant melanoma of ciliary body
Diagnosed very late as it is hidden; it can extend anteriorly, posteriorly or grow circumferentially thereby causing specific presentations each.
In early stage it is localised and affects the ciliary body only leading to hypotony and defective vision + localised Episcleral vein dilatation.
It can appear as a structure pushing the iris edges inwards
If it grows anteriorly it causes damages to the lens such as cataract, subluxation or anterior displacement as well as involving the iris which is immediately visible and this all leads to secondary glaucoma .
If it grows posteriorly then choroidal damage and signs will be apparent as well as exudate retinal detachment.
Usually it is treated by enucleation of if it is detected in time resection of ciliary body alone or + affected structures.
Tumours of the iris
Most common lesion of iris= Naevus which is a flat, pigmented circumscribed lesion of different sizes and it can become malignant
Malignant melanoma is presented as a vascular nodule/nodules growing rapidly which can spread into the angle producing secondary glaucoma or penetrate the limbus
It can be treated with Ectomy of Iris and affected structures or enucleation.