Ultrasonography and 32P test in diagnosis of malignant melanomas in eyes with hazy media.

OPHTHALMOLOGISTS ARE FAMILIAR WITH THE DIFFICULTIES WHICH MAY OCCUR IN making the clinical diagnosis of uveal melanoma. 1-3 In eyes with clear media, newer diagnostic approaches have helped to alleviate some of these difficulties.4'5 However, when hazy media prevent an adequate view of the fundus the diagnosis may be extremely difficult. 3,648 In such cases, the patient may be subjected to cataract extraction, glaucoma surgery, retinal detachment surgery, retrobulbar alcohol injection, and various topical and systemic medications, while the underlying tumor remains unrecog-nized.3 611 Many of these eyes are eventually enucleated because of absolute glaucoma or other complications, while the tumor is still unsuspected. In other cases, the eye may be enucleated because the possibility of a tumor is eventually considered. Even then, the diagnosis is usually a presumptive one, which can only be confirmed if enucleation is performed. The use of ultrasonagraphy,12-14 and the radioactive phosphorus (32p) uptake test'520 have improved the clinician's ability to diagnose posterior uveal melanomas. Reports to date indicate that these two procedures have been used primarily to help confirm the diagnosis of melanoma in eyes with clear media, 1316 although their combined use has been suggested in eyes with opaque media. 14 the in eyes with hazy media a 14

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