Which clinical history findings are characteristic of ciliary body melanoma?

Updated: Mar 03, 2020
  • Author: Enrique Garcia-Valenzuela, MD, PhD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

Ciliary body melanomas can remain asymptomatic until they grow enough to affect neighboring ocular structures. Patients may present with the following symptoms:

  • Blurred vision
  • Floaters
  • Painless visual field loss
  • Photophobia
  • Severe ocular pain

Blurred vision may occur consequent to growth of the melanoma into the crystalline lens, leading to lenticular astigmatism or cataract; they may also block the visual axis directly or via an intraocular hemorrhage.

Floaters can be reported when areas of necrosis within the tumor or adjacent structures produce vitreous hemorrhage or hyphema.

Painless visual field loss may be present as the melanoma grows centrally and posteriorly.

Photophobia may result from anterior uveitis.

Severe ocular pain occasionally can be associated with ciliary body melanoma, secondary to high intraocular pressure because of acute angle-closure glaucoma.

A history of weight loss, marked fatigue, cough, or change in bowel or bladder habits should prompt consideration of primary nonocular malignancy with ciliary body metastasis.


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