Introduction:

Iris melanoma, also known as uveal melanoma or melanoma of the iris, is a rare type of intraocular tumor that originates from the melanocytes in the iris. In this article, we will explore the characteristics of iris melanoma, its clinical presentation, diagnostic methods, treatment options, and the importance of early detection for a favorable prognosis.

Characteristics of Iris Melanoma:

1. Origin: Iris melanoma arises from the pigment-producing cells called melanocytes in the iris, the colored part of the eye.
2. Malignant Nature: Iris melanoma is a malignant tumor, which means it has the potential to spread to other parts of the eye and body.
3. Unilateral Occurrence: Iris melanoma typically affects only one eye, and it is uncommon for it to develop in both eyes simultaneously.

Clinical Presentation:

The presentation of iris melanoma can vary depending on the tumor size, location, and extent of involvement. Some common signs and symptoms include:

1. Change in Iris Color: Patients may notice a change in the color of their iris, such as darkening or the appearance of new pigmented areas.
2. Iris Nodules: Iris melanoma can manifest as elevated or pigmented nodules on the iris surface.
3. Glaucoma: Large iris melanomas can block the eye's drainage system, leading to increased intraocular pressure and secondary glaucoma.

Diagnosis and Evaluation:

Diagnosing iris melanoma involves a comprehensive ophthalmic examination and specialized imaging studies. The following diagnostic methods are commonly used:

1. Slit-Lamp Biomicroscopy: Ophthalmologists use a slit lamp to examine the iris closely and assess any suspicious lesions.
2. Gonioscopy: This technique allows the visualization of the angle structures of the eye to evaluate tumor extension into the anterior chamber.
3. Ultrasound Biomicroscopy (UBM): UBM provides high-resolution images of the iris and ciliary body, aiding in tumor assessment.
4. Fundus Examination: Dilated fundus examination helps evaluate the tumor's impact on the posterior segment of the eye.

Treatment Options:

Treatment for iris melanoma depends on factors such as tumor size, location, and the extent of invasion. The following options may be considered:

1. Surgical Resection: Small, localized iris melanomas may be treated with surgical resection, removing the tumor while preserving as much healthy iris tissue as possible.
2. Iridectomy: In some cases, a partial or complete removal of the iris (iridectomy) may be necessary.
3. Radiation Therapy: Radiation, including plaque brachytherapy or proton beam therapy, may be employed for medium to large tumors to destroy cancer cells.

Importance of Early Detection:

Early detection of iris melanoma is crucial for favorable treatment outcomes. Regular eye exams, especially for individuals at higher risk due to factors such as fair skin and light-colored eyes, can lead to early identification and timely intervention.

Conclusion:

Iris melanoma is a rare and potentially malignant intraocular tumor originating from melanocytes in the iris. Early detection and appropriate management are essential for preserving vision and achieving favorable outcomes. Regular eye examinations play a pivotal role in diagnosing and treating iris melanoma promptly.

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