Detection of uveal melanoma by optometrists in the United Kingdom.

In the United Kingdom, most uveal melanomas are detected by optometrists. Prospectively collected data on patients with uveal melanoma presenting to optometrists were analysed retrospectively to determine: (a) the proportion of patients who were asymptomatic at the time of tumour detection, (b) the proportion of symptomatic patients reporting that their tumour was missed at their initial presentation and (c) the clinical features related to immediate tumour detection. The 223 patients had a mean age of 59.7 years, a mean tumour diameter of 11.3 mm and a mean tumour thickness of 4.6 mm. Symptoms were present in 122 patients (55%) and were associated with large tumour size (p < 0.0001) and male gender (p = 0.003), with more males tending to have a large tumour (p = 0.004). Seventy-nine percent of symptomatic patients reported that their tumour was detected at their first visit. Failure of tumour detection in symptomatic patients was associated with absence of tumour extension posterior to equator (p < 0.0001).