Pain can occur with invasion of ciliary nerves. Patients are rarely asymptomatic. Other signs include vitritis, posterior uveitis, choroidal effusions, detachments, disc edema, vitreous hemorrhage. It is important to distinguis primary uveal melanoma from metastatic disease. Metastatic lesions are usually flat, multifocal, and often bilateral.
Retinal detachments are common.
Primary uveal melanoma is usually unifocal, mushroom shaped, bulky, slow growing, and often ruptures through Bruch's membrane. Anterior uveal metastases are infrequent. Present with decreased acuity and pain. The most common signs are anterior uveitis and red eye. Ciliary metastases cause shallow anterior chamber, subluxated lens, cataract, spontaneous hyphema.