One of the most common pigmented lesions is a choroidal naevus, sometimes described as an eye mole or freckle at the back of the eye.

Most choroidal naevi are harmless and do not require treatment. However, certain lesions may have characteristics that warrant closer examination to distinguish them from early choroidal melanoma.

Importantly, ocular lesions often cause no symptoms and may only be discovered during routine eye examinations or retinal imaging.

When Does an Ocular Lesion Require Specialist Assessment?

Certain characteristics can indicate that an ocular lesion requires closer investigation. These include changes in size or shape, increased thickness, orange pigmentation, fluid beneath the retina or documented growth over time.

No single feature necessarily confirms malignancy. Instead, specialists consider the overall clinical appearance, imaging findings and any changes observed during monitoring.

One important development in this field is the MOLES scoring system, created by Professor Bertil Damato to help clinicians assess suspicious pigmented lesions within the eye.

MOLES evaluates five characteristics: Mushroom shape, Orange pigment, Large size, Enlargement and Subretinal fluid.

The scoring system supports decisions about monitoring and referral, helping identify lesions that may require specialist investigation. It does not replace clinical judgement or a comprehensive ophthalmic examination.

Where an ocular tumour is suspected, prompt assessment through an appropriate specialist pathway is important. New visual symptoms, particularly sudden loss of vision, should also be assessed urgently.

The Importance of Advanced Diagnostic Imaging

Modern ophthalmic imaging plays a central role in the assessment and monitoring of ocular lesions.

At The Retina Clinic London, patients benefit from access to some of the latest ophthalmic diagnostic technologies, including:

• Ultrawidefield retinal imaging: Captures detailed images of the retina, documenting lesions and allowing comparison over time.
• Optical coherence tomography (OCT): Provides high-resolution cross-sectional images of the retina, helping identify structural changes and fluid associated with certain lesions.
• Fundus autofluorescence: Reveals changes in retinal pigment that may assist in characterising suspicious lesions.
• Additional specialist investigations: Including ocular ultrasonography where required to assess tumour dimensions and characteristics.

Combining these complementary investigations with specialist clinical examination can provide a more complete understanding of a lesion and help guide appropriate management.

Specialist Ocular Oncology at The Retina Clinic London

The Retina Clinic London’s dedicated Ocular Oncology Service is led by Professor Bertil Damato, an internationally recognised Consultant Ophthalmologist and Ocular Oncologist with more than four decades of experience in the diagnosis and management of eye tumours.

As an integral member of the clinic’s consultant team, Professor Damato works alongside experienced ophthalmic specialists, including vitreoretinal surgeons, bringing together specialist ocular oncology expertise, advanced diagnostics and surgical capabilities within a coordinated clinical service.

Prompt Assessment and Access to Treatment

The clinic aims to provide timely specialist appointments, allowing patients with suspicious ocular lesions to receive detailed clinical assessment without unnecessary delay, subject to clinical urgency and availability.

Where appropriate, selected ocular tumour procedures and associated retinal interventions can be performed within the clinic’s dedicated onsite operating theatre, with access to specialist vitreoretinal surgical expertise.

For patients requiring radiotherapy or other procedures not provided onsite, the clinic can coordinate treatment through appropriate external specialist centres.

Continuity of Care and Long-Term Monitoring

A key feature of The Retina Clinic London’s approach is its commitment to continuity of care.

Patients are not routinely discharged following their initial assessment or treatment. Instead, the clinic offers ongoing specialist follow-up where clinically indicated, with monitoring tailored to each patient’s condition.

This is particularly valuable for ocular lesions that require observation over time or for patients who have undergone treatment and need continued ophthalmic assessment.

By maintaining continuity with the same clinical team and access to previous diagnostic imaging, the clinic can provide consistent, personalised care throughout the patient journey.

Specialist Assessment and Referrals

Whether an ocular lesion has been identified during a routine eye examination, requires further investigation or has previously undergone treatment, specialist assessment can help establish the most appropriate next steps.

The Retina Clinic London welcomes enquiries from patients, optometrists and referring ophthalmologists seeking specialist ocular oncology assessment in London.

Previous retinal images and relevant clinical records can be particularly helpful when evaluating changes over time.

Learn more about Professor Bertil Damato and our Ocular Oncology Service.

To enquire about a consultation, please call +44 (0)20 4548 5310 or visit The Retina Clinic London.