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December 1972


Author Affiliations


Arch Ophthalmol. 1972;88(6):696-697. doi:10.1001/archopht.1972.01000030698028

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To the Editor.  —With respect to the letter by Dr. Ruiz concerning our article, we do not entirely agree with the first point he made, that no one can look at a fundus lesion and say with certainty that it is or is not malignant. Most malignant melanomas, when first seen by the ophthalmologist, have a rather typical appearance to indirect ophthalmoscopy and should offer little diagnostic problem. In such cases, we think that the diagnosis can be made with virtual certainty on the basis of indirect ophthalmoscopy alone. We agree, however, that in the case of small, relatively flat lesions, the diagnosis may be difficult to impossible. The Retina Service at Wills Eye Hospital has performed about 100 32P studies during the last 18 months and we share the enthusiasm for 32P testing in such cases. However, we do not consider it to be the final answer

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