Submitted by: Joshua Huang
Reviewed and approved by: Dr. Marie-Josée Aubin, Dr. Anne Xuan-Lan Nguyen

What is Uveal Melanoma?

Uveal melanoma (commonly referred to as ‘intraocular melanoma’) encompasses melanomas that arise in the iris, ciliary body, and choroid, all of which make up the uvea or uveal tract. The uvea is the second most common location for the development of melanoma, after the skin, and uveal melanoma is the most common primary intraocular cancer in adults. Although it is rare (it affects 5 adults out of 1 million people each year), it can lead to vision loss, eye loss and even death.

Symptoms

Although most patients are asymptomatic, symptoms can include:

• Blurry vision
• Flashes or photopsia
• Floaters or spots in your vision
• Visual field loss
• Visible dark spot on your iris
• Pain (uncommon)

Risk Factors

• Older individuals (peak age of 70)
• Existing skin moles,iris or choroidal nevi
• Fair skin and light eye colour
• Skin that burns easily with an inability to tan
• Arc welding
• Indoor suntan bed use
• Note: Although sunlight is a risk factor for cancers of the skin and the ocular surface, its association with uveal melanoma is controversial and has not been established

Diagnosis

1. Complete eye examination, including a dilated view of the back of the eye (fundus)
2. Ocular ultrasonography (B-scan)

Treatment Options

• Based on size and location
• Includes observation, resection, radiation therapy, or enucleation
• Immunotherapy if the cancer has spread (metastasis)

Conclusion

Despite advancing uveal melanoma treatment modalities, there has been no change in survival over the last 50 years. Therefore, awareness and prevention are critical to improving outcomes. talk to your doctor or eye care provider for a complete annual eye exam.

The University of Alberta and ACUPO are eager to present: Tuesdays with the Titans: Ophthalmology Update and Review Lecture Series. This is a series of webinars that will be hosted on Tuesday evenings from 5:30 – 7:30 PM, MST. Learners are expected to:

• Apply the latest updates in comprehensive ophthalmology
• Review the 10 ophthalmic subspecialties prior to OKAP and the Royal College written exams.

The schedule is as follows:

These webinars are eligible for MOC Section 1 Credits. Please contact [email protected] for registration information.

To ensure you make the most of your learning activities, the Canadian Ophthalmological Society has curated some resources to help you maximize your MOC credits.  

Discover how to make the most of your CPD activities and maximize your MOC credits throughout the year. This interactive mini-module guides you through a practical case study featuring Dr. Smith, who demonstrates how to turn diverse learning activities into optimal credit opportunities.

For the best user experience, we recommend accessing the course on a computer using a web browser. However, the module can still be accessed on a mobile device.

November is Diabetes Awareness Month, a time to highlight the critical role ophthalmologists play in managing diabetic eye disease. To support your practice, the Practice Resource Centre has compiled a curated list of insightful journal articles, clinical guidelines, and patient resources focused on diabetic retinopathy and related complications. Explore these valuable tools to stay informed and enhance patient care.

For Guidelines:

Diabetes Canada – Diabetic Retinopathy Guidelines

American Academy of Ophthalmology – Guidelines on Diabetic Eye Care

For Articles:

Retinal Physician – The Evolution of Clinical Trial Endpoints for Diabetic Retinopathy

JMIR Diabetes – Implementation of Artificial Intelligence–Based Diabetic Retinopathy Screening in a Tertiary Care Hospital in Quebec: Prospective Validation Study

Canadian Journal of Ophthalmology – Spectral-domain OCT characteristics of intraretinal hyper-reflective foci associated with age-related macular degeneration and diabetic retinopathy

Canadian Journal of Ophthalmology – Long-term visual outcomes and fluid compartment changes in limited-early versus early response to anti-VEGF treatment for diabetic macular edema

Canadian Journal of Ophthalmology – https://www.canadianjournalofophthalmology.ca/article/S0008-4182(24)00173-X/abstract

For Consensus Statements:

Ophthalmology and Therapy – Diabetic Disease of the Eye in Canada: Consensus Statements from a Retina Specialist Working Group

For Correspondence:

Canadian Journal of Ophthalmology – Acute bilateral diabetic papillopathy in a child

Date: Friday, November 8th, 2024

Time: 7:30 AM – 8:30 AM (Eastern Standard Time)

Title: Lessons Learned from Uveitis Cases

Speaker: Dr. Nisha Acharya

Zoom link: Register in advance for this webinar

After registering, you will receive a confirmation email containing information about joining the webinar.

Objectives:

1. To understand the pros and cons of systemic vs. local therapy for the management of uveitis;

2. To become familiar with the evidence available to guide management of uveitic macular edema;

3. To learn about prevention strategies for herpes zoster ophthalmicus.

The VPP Grand Rounds Local and Visiting Professor Program is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada. You will be able to claim 1 credit for this round.

Date: Thursday, November 7th, 2024

Time: 7:30 – 9:30 PM (Eastern Standard Time)

Title: Cell therapy for Corneal Endothelial Dystrophies

Speaker: Dr. Joshua Teichman

Zoom Link: Register in advance for this webinar

After registering, you will receive a confirmation email containing information about joining the webinar.

Objectives:

1. Understand the current standard of care in the management of corneal endothelial dysfunction;

2. Describe medical and surgical options for treatment of symptomatic Fuchs dystrophy and bullous keratopathy;

3. Learn about future alternatives for corneal endothelial cell replacement.

The VPP Grand Rounds Local and Visiting Professor Program is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada. You will be able to claim 1 credit for this round.

Wills Eye Hospital and the University of Toronto are excited to bring you the next installment of the Cornea Surgical Video Learning Series:

Date: Thursday, September 19th 2024
Time: 19:30 – 21:00 EST
Location: Virtual

Keynote Presentation:
Professor Michael Snyder, MD, Department of Ophthalmology, University of Cincinnati

Guest panelists: Joshua Teichman, MD FRCSC and Randal Ulate, MD (University of Toronto),
Zeba Syed, MD and Brenton Finklea, MD (Wills Eye Hospital)

Surgery Case Presentations: Rohini Sigireddi, MD (Wills Eye Hospital), Mor Baraket, MD(University of Toronto)

Register in advance for this webinar: https://us02web.zoom.us/webinar/register/WN_ABOjHTL9Rmu7NS9Oh9V1Ag

After registering, you will receive a confirmation email containing information about joining the webinar.

The evening will as usual be recorded and placed online for viewing.

If you would like to visit any of our prior series, please see the link here:

https://ophthalmology.utoronto.ca/subspecialty-rounds

CME credits are available for the following:

· Royal College Maintenance of Certification Section 1: 7.5 hours (1.5 Section 1 hours per session)

· American Medical Association Category 1: 7.5 credits (1.5 Category 1 credits per session)

· European Union for Medical Specialists UEMS-EACCME®: 7.5 credits (1.5 ECMEC credits per session)

Date: August 24th – 25th, 2024

Time: 4:00 PM – 9:00 PM IST

The 4th Global Neuro-Ophthalmology Case Festival is a two-day celebration of learning, focused on common, complex, and important neuro-ophthalmology disorders with diverse speakers and expert panelists.

The Case Festival will be available for free on YouTube.

Click HERE to access the August 24th livestream

Click HERE to access the August 25th livestream.

The Royal College is excited to launch the MOC Learn & Connect Series which will provide details on the new changes to the MOC framework, as well as share the educational strategies that will support the medical community.

At the end of this session, you will be able to:

• Describe the motivation and rationale for updating the MOC program;
• Identify key elements of the updated MOC program, including new learning activities, section descriptions, cycle requirements and other changes;
• Explain each section of the refreshed MOC program to promote meaningful learning.

In addition to these virtual events, the MOC Learn & Connect series includes pre-recorded videos and opportunities for live Q&A with MOC team members.

MOC Credits

This event is an Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada and approved by the Royal College Learning Improvement Unit. You may claim a maximum of 1 hour.

To register, CLICK HERE.

Questions? Contact the Royal College Services Centre at (613) 730-6243, 1-800-461-9598 or [email protected]