OSSN
• Ocular surface squamous neoplasia• Encompasses conjunctival/corneal
intraepithelial neoplasia (CIN)
• Squamous conjunctival dysplasia• Carcinoma in situ• Invasive squamous cell carcinoma
(SCC)
Conjunctival melanoma
• Primary aquired conjunctival melanosis (PAM)
• Preexisting conjunctival naevus• De novo
Rx Conjunctival SCC / Melanoma
• Excision / cryotherapy to cut conjunctival margin
• Topical Mitomycin C• Episcleral plaque radiotherapy if
recurrence
• Symptoms• Thickness > 2mm• Orange pigment (lipofuscin)• Growth• Subretinal fluid• Peripapillary location
Uveal melanoma treatment
• Observation• Transpupillary laser thermotherapy
(TTT)
Posterior pole
Thickness < 3.5mm
Uveal melanoma treatment
• Observation• TTT• Local resection• Radioactive plaque therapy
Thickness < 8mmBase <15mm
Uveal melanoma treatment
• Observation• TTT• Local resection• Radioactive plaque therapy• Proton beam/helium ion irradiation• Gamma knife therapy
Uveal melanoma treatment
• Observation• TTT• Local resection• Radioactive plaque therapy• Proton beam/helium ion irradiation• Gamma knife therapy• Enucleation
Base > 15mm
Metastatic tumours
• Breast / lung carcinoma
• Amelanotic• Multifocal• Choroidal
• Treat only if sight affected