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Metachronous ispilateral conjunctival then choroidal melanoma
  1. P T Finger1,2,
  2. C E Iacob2,
  3. S A McCormick2
  1. 1The New York Eye Cancer Centre, New York City, New York, USA
  2. 2The New York Eye and Ear Infirmary, New York City, New York, USA
  1. Correspondence to: Paul T Finger The New York Eye Cancer Centre, 115 East 61st Street, New York City, New York 10021, USA; pfinger{at}eyecancer.com

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Conjunctival melanomas have been reported to invade the cornea, sclera, eyelids, and orbit. Reports of intraocular invasion are rare.1–3 We have found no reports of ipsilateral metachronous primary conjunctival then choroidal melanoma.

Case report

A 79 year old woman presented to the New York Eye Cancer Centre with a history of biopsy proved conjunctival melanoma. Examination revealed a visual acuity of 20/20 in both eyes. Conjunctiva melanosis (AJCC-T3) was noted to involve the entire bulbar surface, extending onto the cornea and into both fornices (fig 1).4,5 No evidence of deep scleral invasion or intraocular extension was noted by ophthalmoscopy or high frequency ultrasonography. Treatment required local resection with adjuvant cryotherapy.6 All nodular conjunctival tumours and corneal epithelial melanosis (plus 2 mm margins) were removed. Removal of the subconjunctival tumour required a lamellar sclerectomy. Adjuvant cryodestruction was applied …

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