Congenital Ocular Melanocytosis

Melanocytosis
Fig. 8.11 a, b. Ocular melanocytosis. a Heterochromia with light brown right iris and dark brown left iris. b Episcleral melanocytosis

Although it is not strictly in the conjunctiva, congenital ocular melanocytosis is included here because it is an important epibulbar lesion of childhood. It is a congenital diffuse, patchy epibulbar pigmentation that is situated deep to the conjunctiva in the sclera (Fig. 8.11). There is usually diffuse pigmentation of the ipsilateral iris, causing heterochromia iridium. If the pig mentation extends onto the surrounding eyelid, it is called oculodermal melanocytosis, or nevus of Ota. Patients with congenital ocular melano-cytosis have a higher incidence of malignant melanoma of the uveal tract, usually later in life [48]. Occasionally a uveal melanoma can occur in a child with ocular melanocytosis. It has been estimated that eyes with ocular melanocytosis carry a 1/400 lifetime risk for uveal melanoma [48]. Hence an ophthalmologist should perform a fundus examination every year.

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