August 9, 2012 | POSTED BY | Clinical Pearls

What is the most fundamental key in determining if anterior segment pigmentation warrants further investigation? Location! Location! Location! Why?

  • Remember, there are certain parts of the anterior segment where pigmentation typically does not occur. If you see changes in these areas, the presentation is likely a more serious one.
  • Where to look? The palpebral conjunctiva is the place to start! If you see significant pigmentation on the upper tarsal plate or inferior fornix, be sure to refer to a surgeon! The upper tarsal plate and inferior fornices are ATYPICAL for pigmentation and are an indication for melanoma.
  • Melanomas have a mortality rate of 28%, so early identification and intervention are essential!

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