The condition is painless unless severe glaucoma develops. The diagnosis is made by biopsy of extraocular extension or chorioretina. Lymphoid hyperplasia of the uvea often responds to corticosteroids and moderate dose of radiotherapy. Primary choroidal melanomas can present as focal choroidal mass, which may mimic sarcoidosis, tuberculous granuloma, or posterior scleritis. Uveitis, as described in the second case above, is rarely associated with ciliary body melanoma.
Patients often present with loss of vision.
The fundus can appear normal early in the course of the disease. However, there may be eventual vascular sheathing, disturbances of the RPE, and optic disc pallor. This condition can occurs in patients with carcinomas, but underlying processes are often occult. Histopathology reveals diffuse uveal tract infiltrates with benign, spindle-shaped melanocytic cells, which have foamy cytoplasm, but lack mitotic figures. In addition, there may be episcleral injecition, vitritis, and exudative retinal detachment.