Good Hope, Heartlands, and Solihull Eye Clinics

Naevi

David Kinshuck

 

Introduction

A retinal naevus or nevus is a brownish freckle like mark on the retina. Small flatter naevi are benign and cause no problems.

In the UK optometrists may notice naevi, and refer patients to their ophthalmologist. Patients with small flat lesions may then be discharged from the eye clinic, but some will still need to be checked by their optometrist each year to see if there is any change. Preferably patients should be provided with a retinal photo to take to their optometrist, so he can use it for comparison. Abstract.

A very small number of larger thicker naevi do develop into melanomas, a type of cancer. Thick large naevi may already be melanomas, and expert advice is needed.A few patients will have to be checked regularly in the eye clinic, and other patients will need a detailed examination to determine if there is a melanoma that needs more treatment.

Suspicious features of melanoma

  • size......................................is it the same as before
  • elevation...............................thicker lesions are suspicious
  • boundary..............................is the edge smooth & regular
  • satellite lesions.....................are there any? (suspicious)
  • drusen..................................lipofuscin, like barnacles, benign
  • subretinal fluid..if present....highly suspicious
  • when to refer  .......................> l inks  > referral guide
  • ectropian uveae....................no cause of concern
  • 30% naevi............................no symptoms...visible to optometrist

OCT  for ocular tumours