Date of last review: Due to be updated

Differential diagnosis

  • Conjunctival intraepithelial squamous neoplasia

Possible management by Optometrist

Treatment

  • None

Advice

  • Ethnic melanosis has no malignant potential and requires no treatment
  • Naevus
    • Advise patient to report any increase in size, elevation or colour
    • Review after 6 months and then every 12 months if lesion unaltered
    • Generally requires no treatment
    • Photo-documentation advised
    • Very rarely progresses to a malignant melanoma 
  • Congenital Ocular Melanocytosis
    • Screen regularly for glaucoma
  • Primary Acquired Melanosis
    • Mild cases can be observed
    • Any atypical features or change should be referred
  • Malignant Melanoma
    • Refer urgently

Management Category

  • Refer urgently
    • Melanoma (within one week)
  • Refer routinely
    • Primary Acquired Melanosis/Conjunctival-Melanolcytic Intra-Epithelial Neoplasia
    • Naevus if atypical, especially if non-bulbar conjunctiva is involved
    • Congenital Ocular Melanocytosis

Possible management by Ophthalmologist

  • Biopsy
  • Excision with double freeze-thaw cryotherapy to excised margins
  • Exenteration if unresectable