Pseudomelanoma and Cataract

AM is a 75-year-old woman who was scheduled for cataract surgery on a 4+ nuclear sclerotic lens. The ophthalmologist had difficulty visualizing the fundus and performed a B-scan examination. When the probe was placed on the posterior temporal sclera against the orbital rim and aimed towards the cornea, a dome-shaped mass was imaged (Fig. 335). The diagnosis of a probable ciliary body melanoma was made and the patient was referred to an oncologist to be evaluated for systemic metastases. The workup was negative for tumor and a discussion was instituted regarding treatment options, including enucleation. This greatly concerned the patient and she sought a second opinion.