Uveal melanoma physical examination: Difference between revisions

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Revision as of 04:12, 30 October 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Common physical examination findings of uveal melanoma include presence of dark spot on the iris, anisicoria, loss of peripheral vision, decreased visual acuity and photopsia.

Physical Examination

HEENT

Eye examination

Dark spot is present on the iris
Anisicoria
Loss of peripheral vision
Decreased visual acuity
Photopsia
Visual field tests

The ophthalmologist uses the following instruments to look inside the eye for a tumor:

An ophthalmoscope (also known as a direct ophthalmoscope).
An indirect ophthalmoscope and a slit lamp is more like a large microscope.
A gonioscopy lens.

References

Template:WikiDoc Sources

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 *An [[indirect ophthalmoscope]] and a slit lamp is more like a large microscope.
 *A [[gonioscopy]] lens.
-Diagnosis of uveal melanoma is based on a combination of clinical examination with indirect ophthalmoscopy, [[slit lamp]] biomicroscopy, and [[ultrasonography]]
-*Iris melanomas are detectable by slit lamp biomicroscopy, on the other hand [[ciliary body]] [[tumors]] are hidden behind the iris and can be visualized by ultrasonography. Depending on their location, [[choroidal]] [[tumors]], are diagnosed by dilated indirect ophthalmoscopy and ultrasonography.
-*Indirect ophthalmoscopy through a dilated pupil provides a correct diagnosis in more than 95% of the cases. Accuracy of the correct diagnosis is established to be over 99% by experienced clinicians with [[ophthalmoscopy]], [[ultrasound]], and [[fluorescein angiography]] and confirmed by histopathology.<ref name="vanKoopmans2013">{{cite journal|last1=van|first1=J.G.M.|last2=Koopmans|first2=A.E.|last3=Verdijk|first3=R.M.|last4=Naus|first4=N.C.|last5=de|first5=A.|last6=Kilic|first6=E.|title=Diagnosis, Histopathologic and Genetic Classification of Uveal Melanoma|year=2013|doi=10.5772/53631}}</ref>
-*The clinical diagnosis of uveal melanoma can be made on dilated fundus exam when the classical appearance of a pigmented dome shaped mass extends from the ciliary body or choroid indicating that the tumor has extended through Bruch’s membrane. Approximately 20% of lesions will take on a large, mushroom shape.
-The appearance of melanoma depends on its location and size, whether it is in the [[iris]] or the [[choroid]].
-*Iris melanoma appears as a brown or yellow nodule on the iris. It is usually visible to the patient.
-*Choroidal melanoma appears as a  yellow or brown or tumor in the back of the eye and is not visible to the patient.
 == References ==
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