Headache or Eye Pain as the Presenting Feature of Uveal Melanoma

Uveal melanoma classically presents as a painless intraocular mass. Related features such as retinal detachment, vitreous hemorrhage, or extraocular extension, typically do not generate pain. Pain is rare, found in <1% of cases, and can be caused by severely elevated intraocular pressure from neovascular or angle-closure glaucoma, or it can result from spontaneous tumor necrosis. Often there is delay in diagnosis as the headache or ocular pain is attributed to sinusitis, dental infection, muscle or emotional stress, or migraine etiology.

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