Intraocular tumours
Children
Retinoblastoma is
a multicentric malignant tumour of the retina, which can be bilateral. Some are
sporadic, but many are hereditary. Children with a family history should be
carefully monitored from birth. It is often not spotted until the tumour fills
the globe and presents as a white reflex in the pupil (Fig.
36.12). Differential
diagnosis is from retinopathy of prematurity, primary hyperplasic vitreous and
intraocular infections. If the tumour is large, enucleation may be required, but
radiotherapy, cryotherapy or laser treatment can cure small lesions.
Adults
Malignant
melanoma is
the most common tumour, and it originates in the pigment cells of the choroid
ciliary body (Fig 36.13 and Fig.
36.14) or iris. It can present a reduction in
vision, a vitreous haemorrhage or by the chance finding of an elevated pigmented
lesion in the eye. Growth can be rapid or fairly slow; as a general rule, the
more posterior the lesion