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Sandra M. Brown, MD

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I read with dismay the article by Eagle et al¹ regarding evisceration of eyes harboring unsuspected uveal melanoma. The authors describe 7 cases compiled over an unknown period of time and 2 cases reported in 1967 and 1980. A supportive editorial² identified 2 "additional" patients: the same 1980 case and another of dubious relevance in a Japanese article. This brings the total in the English language literature to 9 cases from 1967 to the present. Eagle and colleagues write, "[We] believe that this complication has been grossly underrepresented in the literature due to medicolegal concerns." Their statement is pure speculation.

The investigators also assert that inadequate preoperative imaging led to inappropriate treatment. In the 4 cases with imaging studies, melanoma was not suspected. Only in case 1 did a computed tomographic scan showing "choroidal thickening" suggest that malignancy might be in the differential diagnosis. Although the . . . [Full Text of this Article]

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RELATED LETTERS

Should Evisceration Ever Be Done in a Blind, Painful Eye?
Amy C. Schefler and David H. Abramson
Arch Ophthalmol. 2009;127(2):211-212.
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Evisceration of Blind, Painful Eyes With Occult Uveal Melanoma Not a Crime—Reply
Ralph C. Eagle, Jr, Hans E. Grossniklaus, Nasreen A. Syed, R. Nick Hogan, William C. Lloyd, III, and Robert Folberg
Arch Ophthalmol. 2009;127(9):1229.
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Inadvertent Evisceration of Eyes Containing Uveal Melanoma
Ralph C. Eagle, Jr, Hans E. Grossniklaus, Nasreen Syed, R. Nick Hogan, William C. Lloyd, III, and Robert Folberg
Arch Ophthalmol. 2009;127(2):141-145.
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