The most common signs are anterior uveitis and red eye. Ciliary metastases cause shallow anterior chamber, subluxated lens, cataract, spontaneous hyphema. Secondary tumors arise from direct extension from adjacent structures such as the globe, nasal cavity, and sinuses. Retinal metastases are rare and cause vitreous seeding, can be confused with retinitis. Usually present with uveal metastases and often with brain metastases.
Vitreous metastases occur with metastatic melanoma and present with floaters.
Painless nodule is most common symptom. Often mistaken for chalazion or primary skin tumor. Lesions show high reflectivity in characteristic V-pattern. Lower reflectivity in the center of the lesion due to higher cell density. Iris fluoroscein angiography and AC paracentesis, fine needle biopsy for anterior lesions.