Management of ocular melanoma

Most melanomas in the orbital region are primary tumours. The uveal tract is the commonest site though the skin of the eyelids, the conjunctiva and, very occasionally, the orbit itself may be involved. Direct spread may cause the tumour to present in an adjacent structure so that a uveal tract melanoma with an extrascleral nodule may appear to arise in the conjunctiva or in the orbit whilst a conjunctival melanoma may first be apparent in the adjacent eyelid skin. Metastatic deposits from cutaneous melanoma may occasionally present in the eye or ocular adnexa.