• My Dashboard My Education Find an Ophthalmologist
  • Home
  • For Ophthalmologists
    • Meetings
      • AAO 2021
        • Meeting Information
          • Past and Future Meetings
          • Contact Information
          • Virtual Meeting Guide
          • Policies and Disclaimers
        • Program
          • Program Search
          • Program Highlights
          • Program Committees
          • CME
          • Meeting Archives
        • Expo
        • Registration
        • Hotels & Travel
          • Hotel Reservation Information
          • New Orleans
          • International Attendees
          • Hotel Meeting Space
        • Presenter Central
          • Presenter Central
          • Abstract Selection Process
          • Submission Policies
          • Subject Classification/Topics
          • Instruction Courses and Skills Transfer Labs
          • Papers and Posters
          • Videos
          • Grand Rounds Symposium
          • Program Participant and Faculty Guidelines
          • Faculty Development Program
        • Exhibitors
          • Exhibitor Central
          • Exhibitor Portal Information
          • New Exhibiting Companies
          • Exhibitor Resources
      • Mid-Year Forum
        • Registration and Travel
        • Congressional Advocacy Day
        • Advocacy Ambassador Program
        • Program
        • Schedule
        • Sponsored Attendees
        • News
      • Ophthalmology Business Summit
      • Codequest
        • Codequest Instructors
        • Claim Codequest CME or CEU Credit
      • Eyecelerator
    • Clinical Education
      • COVID-19
      • Education
        • Browse All Education
        • Courses
        • Cases
        • Learning Plans
        • Interactive
        • Focal Points
        • Wills Eye Manual
        • Disease Reviews
        • Clinical Webinars
        • Diagnose This
        • Self-Assessments
        • Educational Centers
          • Glaucoma Education Center
          • Pediatric Ophthalmology Education Center
          • Laser Surgery Education Center
          • Myopia Resources
          • Oculofacial Plastic Surgery Center
          • Redmond Ethics Center
      • Journals
      • Guidelines
        • Browse All Practice Guidelines
        • Preferred Practice Patterns
        • Clinical Statements
        • Compendium Guidelines
        • Complementary Therapy Assessments
        • Medical Information Technology
        • Ophthalmic Technology Assessments
        • Patient Safety Statements
        • Choosing Wisely
        • Low Vision
        • Eye Care for Older Adults
        • Eye Disease Statistics
        • About the Hoskins Center
      • Multimedia Library
        • Browse All Videos and Audio
        • Clinical and Surgical Videos
        • Presentations and Lectures
        • 1-Minute Videos
        • Master Class Videos
        • Basic Skills Videos
        • Interviews
        • Audio and Podcasts
        • Images
        • Submit an Image
        • Submit a Video
      • News
        • Browse All Clinical News
        • Editors' Choice
        • Headlines
        • Current Insight
      • CME Central
        • Browse All CME Activities
        • Claim CME Credit and View Transcript
        • CME Planning Resources
        • Complete Your Financial Disclosure
        • Joint Sponsorship Portal
        • LEO Continuing Education Recognition Award
        • Safe ER/LA Opioid Prescribing
        • Check Your Industry Payment Records
      • MOC
      • Resident Education
        • All Resident Education
        • OKAP and Board Exam Resources
          • OKAP Exam
          • Board Prep Resources
          • OKAP and Board Review Presentations
          • Study Flashcards
        • Resident Courses
        • Resident Videos
        • Cataract Master
        • Simulation in Resident Education
        • Pediatric Ophthalmology Education Center
        • News and Advice from YO Info
    • Membership
      • Join
      • Renew
      • Current Member
      • Volunteer
      • Physician Wellness
      • Member Directory
      • Member Obituaries
      • AAOE Membership
    • Advocacy
      • Advocacy News
      • Get Involved
        • Ways to Give
        • How to Get Involved
        • Congressional Advocacy
        • Support the Academy's Agenda
        • Research Legislation
        • Find Your Legislators
        • I Am an Advocate
        • Advocacy at Home
        • Advocate Tools
        • Best Practices for Advocating at Home
        • Social Media Toolkit
        • Letter to Editor
        • Town Hall Guide
        • Guide to Engaging With New Lawmakers
        • Resources
        • Attending a Political Fundraiser
      • OPHTHPAC
        • About Us
        • Join OPHTHPAC
        • OPHTHPAC Blog
      • Surgical Scope Fund
        • Support Surgery By Surgeons
        • Surgery By Surgeons Blog
    • Publications
      • EyeNet Magazine
        • Latest Issue
        • Archive
        • Subscribe
        • Advertise
        • Write For Us
        • Corporate Lunches
        • Contact
        • MIPS 2019
        • MIPS 2020
      • Focal Points
      • Ophthalmology
      • Ophthalmology Glaucoma
      • Ophthalmology Retina
      • YO Info
      • Scope
    • Subspecialties
      • Cataract/Anterior Segment
      • Comprehensive Ophthalmology
      • Cornea/External Disease
      • Glaucoma
      • Neuro-Ophthalmology/Orbit
      • Ocular Pathology/Oncology
      • Oculoplastics/Orbit
      • Pediatric Ophthalmology/Strabismus
      • Refractive Management/Intervention
      • Retina/Vitreous
      • Uveitis
    • IRIS Registry
      • About
      • Using the Registry
        • User Guide
        • Medicare Reporting
        • Maintenance of Certification
        • Non-EHR Reporting
      • Sign Up
        • Application Process
        • Why Participate
        • Once You've Applied: Getting Started
        • What Practices Are Saying About the Registry
      • Requirements
        • EHR Systems
        • Data & Technical Needs
      • Research
      • Registry Dashboard
      • News
    • Medicare Information
  • For Practice Management
    • Coding
      • Codequest
      • Ask the Coding Experts
      • Coding Updates and Resources
      • Coding for Injectable Drugs
      • ICD-10-CM
        • News and Advice
      • Ophthalmic Coding Specialist (OCS) Exam
    • Regulatory
      • Medicare Participation Options
      • Audits
      • Medicare Advantage Plans
        • Termination Appeal Letter
      • New Medicare Card
      • Provider Enrollment, Chain and Ownership System (PECOS)
      • HIPAA Resources
    • Practice Operations
      • Practice Management Advice
      • Lean Management
      • Cybersecurity
      • Private Equity
      • EHRs
        • Overview
        • Planning and Preparation
        • Vendor Selection
        • Implementation and Evaluation
        • Patient Portals
        • Resources
        • Ratings
    • Events
      • Annual Meeting
      • Business Summit
      • Codequest Courses
    • Leadership
      • AAOE Board of Directors
      • Leadership Program (OPAL)
    • Listservs
    • Resources
      • Practice Management Resource Library
      • Coronavirus Resources
      • Patient Education
      • Practice Forms Library
        • Practice Forms Library - Examination
        • Practice Forms Library - Financial
        • Practice Forms Library - HIPAA
        • Practice Forms Library - Human Resources
        • Practice Forms Library - Job Descriptions
        • Practice Forms Library - Patient Forms
        • Practice Forms Library - Protocols
        • Practice Forms Library - Surgery
      • Practice Analytics
        • Benchmarking Tool
        • Salary Survey
      • Consultant Directory
      • Ophthalmology Job Center
      • Practice Management for Retina
      • Reopening and Recovery
    • Get Involved
    • Medicare
      • Quality
        • Overview
        • Reporting
        • Measures
      • Promoting Interoperability
        • Overview
        • Measures
        • Attestation
        • Hardships and Exceptions
        • Audits
        • News and Advice
      • Improvement Activities
        • Overview
        • List of Improvement Activities
        • Attestation
        • Audits
      • Cost
      • Avoid a Penalty
      • Resources
        • 2019 to 2020 MIPS Changes
        • MIPS Solo and Small Practice Survival Guide
        • MIPS Glossary
        • MIPS Resources on EyeNet
        • MIPS Extreme Hardship Exceptions
        • Solo and Small-Practice Roadmap
        • MIPS Manual
        • MIPS Large Practice Roadmap
        • IRIS Registry User Guide
        • CMS Websites
        • 2020 MIPS Payments: Understanding Remittance Advice Codes
        • Final Checklist for EHR/Non-EHR 2019 MIPS Reporting
        • MIPS Tips
        • MIPS Archive
    • Membership
  • For Public & Patients
    • Eye Health A-Z
    • Symptoms
    • Glasses & Contacts
    • Tips & Prevention
    • News
    • Ask an Ophthalmologist
    • Patient Stories
    • No Cost Eye Exams
    • Español
      • A - Z de Salud Ocular
      • Síntomas
      • Anteojos y Lentes de Contacto
      • Consejos y Prevención
      • Noticias
      • Relatos de Pacientes
      • Exámenes de la vista sin costo
      • English
  • AAO 2021
    • Meeting Information
      • Past and Future Meetings
      • Contact Information
      • Virtual Meeting Help
      • Virtual Meeting Guide
      • Policies and Disclaimers
    • Program
      • Program Search
      • Program Highlights
      • Program Committees
      • CME
      • Meeting Archives
    • Expo
    • Registration
    • Hotels & Travel
      • Hotel Reservation Information
      • New Orleans
      • International Attendees
      • Hotel Meeting Space
    • Presenter Central
      • Presenter Central
      • Abstract Selection Process
      • Submission Policies
      • Subject Classification/Topics
      • Instruction Courses and Skills Transfer Labs
      • Papers and Posters
      • Videos
      • Grand Rounds Symposium
      • Program Participant and Faculty Guidelines
      • Faculty Development Program
    • Exhibitors
      • Exhibitor Central
      • Exhibitor Portal Information
      • New Exhibiting Companies
      • Exhibitor Resources
  • About
    • Who We Are
      • What We Do
      • About Ophthalmology
      • The Eye Care Team
      • Ethics and the Academy
      • History
      • Museum of Vision
      • Values
    • Governance
      • Council
      • Board of Trustees
      • Committees
      • Academy Past Presidents
      • Secretariats
      • Elections
      • Academy Blog
      • Academy Staff Leadership
    • Leadership Development
    • Awards
      • Laureate Recognition Award
      • Outstanding Advocate Award
      • Outstanding Humanitarian Service Award
      • International Blindness Prevention Award
      • Distinguished Service Award
      • Guests of Honor
      • Secretariat Award
      • Straatsma Award
      • Achievement Award Program
      • Artemis Award
      • EnergEYES Award
      • International Education Award
      • International Scholar Award
      • Commitment to Advocacy Award
      • Visionary Society Award
    • Financial Relationships
    • Policy Statements
    • Related Organizations
      • Subspecialty/Specialized Interest Society Directory
      • State Society Directory
      • Subspecialty/Specialized Interest Society Meetings
      • State Society Meetings
      • Resources for Societies
    • Year in Review
      • 2019 Year in Review
  • Foundation
    • About
      • Funding Allocations and Sources
      • 2019-2020 Annual Report
      • Annual Report Archives
      • News From the Chair
      • Foundation Staff
    • Our Impact
      • Partners for Sight
      • Donor Spotlights
      • Global Ophthalmic Community
      • Sponsorships
      • Patients and the Public
    • Giving Options
      • Our Supporters
      • Estate and Planned Giving
      • Ophthalmic Business Council
    • Orbital Gala
      • Why Attend
      • Photo Recap
      • Corporate Support Opportunities
      • Tribute Gifts
      • Silent Auction
      • Corporate Sponsors
    • Donate
    • Museum of the Eye Campaign
      • Museum Supporters
  • Museum of the Eye
    • Visit
    • Events
    • Explore
      • Research and Resources
      • Collection Search
      • Previous Exhibits
      • Oral Histories
      • Biographies
    • Volunteer
    • Mailing List
    • Donate
    • About the Museum
      • Museum Blog
  • Young Ophthalmologists
    • YO Info
    • Learn to Bill
    • Engage with the Academy
  • Senior Ophthalmologists
    • Scope
    • Practice Transitions
  • International Ophthalmologists
    • Global Programs and Resources for National Societies
    • Awards
    • Global Outreach
  • Residents
  • Medical Students
×
Log In Create an Account
  • For Ophthalmologists
  • For Practice Management
  • For Public & Patients
  • About
  • Foundation
  • Museum of the Eye
  • COVID-19
  • Journals
  • Education
    • Education
    • Courses
    • Cases
    • Learning Plans
    • Interactive
    • Focal Points
    • Wills Eye Manual
    • Disease Reviews
    • Clinical Webinars
    • Diagnose This
    • Self-Assessments
    • Education Centers
      • Glaucoma Education Center
      • Pediatric Ophthalmology Education Center
      • Laser Surgery Education Center
      • Oculofacial Plastic Surgery Center
      • Redmond Ethics Center
      • Myopia Resources
  • Guidelines
    • Practice Guidelines
    • Preferred Practice Patterns
    • Clinical Statements
    • Ophthalmic Technology Assessments
    • Patient Safety Statements
    • Complementary Therapy Assessments
    • Compendium Guidelines
    • Medical Information Technology
    • Low Vision
    • Choosing Wisely
    • Eye Care for Older Adults
    • Eye Disease Statistics
    • About the Hoskins Center
    • Artificial Intelligence
    • Premium IOLs
  • Multimedia
    • Multimedia Library
    • Video
      • 1-Minute Videos
      • Presentations and Lectures
      • Master Class Videos
      • Basic Skills Videos
      • Clinical and Surgical Videos
      • Interviews
      • Resident Lectures
      • Submit a Video
    • Audio and Podcasts
    • Images
      • Submit an Image
  • News
    • Clinical News
    • Editors' Choice
    • Headlines
    • Current Insight
  • CME
    • CME Central
    • Claim CME Credit and View Transcript
    • CME Planning Resources
    • Complete Your Financial Disclosure
    • Joint Sponsorship Portal
    • LEO Continuing Education Recognition Award
    • Safe ER/LA Opioid Prescribing
    • Check Your Industry Payment Records
  • MOC
  • Residents
    • Resident Education
    • OKAP and Board Exam Resources
      • OKAP Exam
      • Board Prep Resources
      • OKAP and Board Review Presentations
      • Study Flashcards
    • Resident Courses
    • Resident Videos
    • Cataract Master
    • Simulation in Resident Education
    • Diversity and Inclusion Education
    • Pediatric Ophthalmology Education Center
    • News and Advice from YO Info
    • Clinical Education /
    • Book Excerpts /
    • Basic and Clinical Science Course - Excerpt
  • 2020–2021 BCSC Basic and Clinical Science Course™

    Go to Academy Store Learn more and Purchase.

    4 Ophthalmic Pathology and Intraocular Tumors

    Part II: Intraocular Tumors: Clinical Aspects

    Chapter 17: Melanocytic Tumors

    Melanoma of the Choroid and Ciliary Body

    Differential Diagnosis

    This section describes the most common lesions considered in the differential diagnosis of posterior uveal melanoma.

    Accurate diagnosis of a choroidal nevus, discussed earlier in this chapter, is associated with clinical experience and availability of ancillary testing modalities. For the evaluation and management of posterior pigmented lesions with characteristics predictive of growth, patients may be referred to ocular oncology centers. No single clinical factor is pathognomonic for benign versus malignant choroidal melanocytic lesions. Less than 10% of benign choroidal nevi have surface lipofuscin, and 15% or less are associated with subretinal fluid (see Fig 17-8B, D, F). In addition, 11%–58% of choroidal nevi have overlying drusen, a frequency that increases with the age of the patient. The presence of surface drusen reflects chronicity of a melanocytic choroidal tumor but can also be seen in melanomas that have transformed from a formerly quiescent nevus. More than 20% of choroidal melanocytic tumors thicker than 3 mm are melanomas, and far fewer than 1% of those thinner than 1 mm are melanomas. Tumors that are 1–3 mm in thickness are more difficult to classify with certainty on the basis of clinical evaluation alone; therefore, often close surveillance for growth is warranted. The risk of malignancy increases substantially for lesions with a basal diameter larger than 6 mm.

    Risk factors for the growth of small choroidal melanocytic lesions have been well characterized; they include 5 clinical features that have given rise to the mnemonic “to find small ocular melanomas” (see Clinical Pearl).

    CLINICAL PEARL

    Clinical risk factors for growth of choroidal nevi: “to find small ocular melanomas”

    • T hickness of the tumor greater than 2 mm

    • F luid under the retina

    • S ymptoms (eg, metamorphopsia, photopsia, visual field loss)

    • O range pigmentation (lipofuscin) overlying the tumor

    • M argin of the tumor touching the optic nerve head

    The following factors are also concerning for melanoma:

    • larger size at presentation

    • absence of drusen or degenerative RPE changes

    • homogeneous low internal reflectivity on ultrasonography

    • hot spots on fluorescein angiography

    To document growth of the tumor, the clinician may periodically photograph it and perform OCT and/or B-scan ultrasonography. Slow growth does not necessarily suggest or confirm malignancy. In a study of 284 benign choroidal nevi, 31% showed slow, progressive enlargement (median increase in diameter = 1 mm) over a long observation period (7 years or more). The frequency of enlargement may be higher in patients younger than 40 years (54%) than in those older than 60 years (19%). Enlarging nevi may not develop any new lipofuscin or subretinal fluid suggestive of malignant change. Thus, when rapid or progressive growth occurs or new risk factors appear, definitive treatment should be considered.

    When risk factors for growth are identified, transscleral or transvitreal fine-needle aspiration biopsy (FNAB) for cytology and molecular testing is an alternative to observation. Cytologic evaluation of cells obtained by FNAB of a small melanocytic tumor requires an experienced cytopathologist, because cellularity of the FNAB specimen may be low and diagnosis based on samples that typically have limited cellularity is challenging. The role of prognostic molecular testing in this setting remains an area of debate.

    Melanocytoma (magnocellular nevus) of the choroid or optic nerve head typically appears as a dark brown to black elevated lesion. Optic nerve melanocytoma is usually located eccentrically over the optic nerve head and may be elevated. It often has fibrillary or feathery margins as a result of extension into the nerve fiber layer (see Chapter 15, Fig 15-12). Because a melanocytoma rarely transforms into melanoma, it is important to differentiate the two. However, choroidal melanocytomas, particularly large ones, can be challenging to differentiate from choroidal melanomas without biopsy. As mentioned previously, for large or growing lesions, biopsy should be considered.

    Congenital hypertrophy of the RPE (CHRPE) refers to sharply defined, flat, very darkly pigmented lesions that range from 1 mm to more than 10 mm in diameter. Patients are asymptomatic, and the lesion can be noted at any age. In younger patients, CHRPE often appears homogeneously black (Fig 17-11A); in older individuals, foci of depigmentation (lacunae) often develop (Fig 17-11B), and the lesion may slowly enlarge. The histologic findings are identical to those of grouped pigmentation of the retina, also known as bear tracks or grouped CHRPE (Fig 17-11C). In patients with Gardner syndrome, a subtype of familial adenomatous polyposis, the presence of multiple atypical CHRPE-like patches appears to be a marker for the development of colon carcinoma. These lesions are distinct from multifocal CHRPE in that they do not have sectoral distribution and have irregular depigmented margins (Fig 17-11D).

    Patients with age-related macular degeneration (AMD) may present with macular or extramacular subretinal neovascularization, hemorrhage, and fibrosis, accompanied by varying degrees and patterns of pigmentation (Fig 17-12A). Hemorrhage, a finding commonly associated with neovascular (exudative) AMD, usually does not occur with melanomas unless the tumor has broken through Bruch membrane. Clinical evaluation of the fellow eye is helpful in documenting AMD. OCT shows predominantly subretinal and intraretinal abnormalities. Ultrasonography reveals high or heterogeneous reflectivity rather than low internal reflectivity, as well as a lack of intrinsic vascularity. When in doubt, the clinician may use fluorescein angiography to help reveal early hypofluorescence secondary to blockage from the hemorrhage, which is often followed by late hyperfluorescence in the distribution of the choroidal neovascular membrane (Fig 17-12B). Serial observation shows involutional alterations of the evolving disciform lesion.

    Choroidal detachments can be hemorrhagic or serous. They are often associated with hypotony and may develop after ophthalmic surgery in the early postoperative period. Hemorrhagic detachments are often dome shaped, involve multiple quadrants, and may be associated with breakthrough vitreous bleeding. Ultrasonographic findings may closely resemble those of melanoma but may reveal absence of intrinsic vascularity and involution of the hemorrhage over time. Observational management is indicated in most cases. MRI with gadolinium contrast may be beneficial in diagnosing suspicious cases.

    Figure 17-11 Congenital hypertrophy of the RPE (CHRPE), various clinical appearances. A, Large, homogeneously black CHRPE lesion. B, CHRPE with atrophic lacunae. C, Grouped pigmentation of the RPE represents a variant of CHRPE. D, Appearance of the RPE hamartoma associated with familial adenomatous polyposis. Note the depigmented margins and comma shape (oval).

    (Parts A and D courtesy of Alison Skalet, MD, PhD; parts B and C courtesy of Tero Kivelä, MD.)

    Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a spontaneously developing, often asymptomatic, peripheral lesion in el derly individuals that resembles a choroidal detachment. It is often associated with suprachoroidal or subretinal bleeding and lipid exudation; associated retinal detachment is uncommon (Fig 17-12C). PEHCR is thought to be analogous to AMD, and the fellow eye often shows a similar or a nonexudative chorioretinal degeneration. PEHCR almost always involutes spontaneously.

    Choroidal osteomas are benign, presumably acquired bony tumors that typically arise from the juxtapapillary choroid in young adults (more commonly in women) and are bilateral in 20%–25% of cases. The characteristic lesion appears yellow to orange and has well-defined margins (Fig 17-12D). Ultrasonography reveals a high-amplitude echo corresponding to the bony plate and loss of the normal orbital echoes behind the lesion (acoustic shadowing). CT can reveal calcification but is not needed for diagnosis. Choroidal osteomas typically enlarge slowly over many years and can decalcify with time. If they involve the macula, vision is generally impaired. Subretinal neovascularization is a common complication. The etiology of these lesions is unknown, but chronic low-grade choroidal inflammation has been suspected (see Chapter 12).

    Figure 17-12 Conditions simulating posterior uveal melanoma. A, Subretinal hemorrhage secondary to neovascular (exudative) macular degeneration. B, Fluorescein angiography (same patient as in part A) reveals hyperfluorescence and late fluorescein leakage in the central macula associated with the choroidal neovascular membrane, and hypofluorescence associated with blockage of fluorescein transmission due to subretinal blood. C, Peripheral exudative hemorrhagic chorioretinopathy (PEHCR); note the red subretinal (arrows) and dark sub-RPE blood (asterisk).D, Choroidal osteoma with yellow-orange color and well-defined pseudopod-like margins. E, Varix of the vortex vein (arrowheads). This lesion is more likely to be developmental than degenerative. F, Metastasis to the choroid from lung cancer. Note the subretinal hemorrhage (patchy dark areas on the surface of the lesion).

    (Parts A–E courtesy of Tero Kivelä, MD; part F courtesy of Alison Skalet, MD, PhD.)

    Table 17-2 Differential Diagnosis of Amelanotic Choroidal Mass

    Choroidal hemangiomas (see Chapter 18) resemble the surrounding fundus in color and may appear to be lightly pigmented or orange. When a slit beam is passed over the lesion, it can appear to glow. These tumors are often better visualized on infrared imaging obtained with OCT than on fundus photographs. In infrared images, choroidal hemangiomas appear dark. Over time, a serous retinal detachment may develop. These lesions, which are often associated with overlying cystic retinal degeneration, are hyperechogenic on ultrasonography and show a characteristic vascular pattern on fluorescein and indocyanine green angiography.

    Varix of the vortex vein (Fig 17-12E) is found predominantly in the nasal quadrants and can reach 4–5 mm in diameter. When filled with blood, it appears dark. The clinician can diagnose this condition by observing its coincidence with the vortex vein ampulla and by gently compressing the eye during indirect ophthalmoscopy, which causes the varix to deflate.

    Intraocular metastases (Fig 17-12F; see also Chapter 20) are generally amelanotic and thus pale or yellowish, unless they originate from a cutaneous melanoma. Most show moderately high or heterogeneous reflectivity on ultrasonography. Table 17-2 lists additional conditions for consideration in cases with amelanotic choroidal masses.

    • Chien JL, Sioufi K, Surakiatchanukul T, Shields JA, Shields CL. Choroidal nevus: a review of prevalence, features, genetics, risks, and outcomes. Curr Opin Ophthalmol. 2017;28(3):228–237.

    • Mashayekhi A, Siu S, Shields CL, Shields JA. Slow enlargement of choroidal nevi: a long-term follow-up study. Ophthalmology. 2011;118(2):382–388.

    Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.

  • Most Commented
    Loading, please wait...
    There are no comments available.
    Most Viewed
    Loading, please wait...
    Most Viewed content is not available.
  • The Academy Store
    2021 North Carolina Codequest (Recording)
    2021 Tennessee Codequest (Recording)
    2021 Codequest (Recording)
    2021 Michigan Codequest (Recording)
    Focal Points 2020 Complete Set
    2021 Coding Coach: Complete Ophthalmic Coding Reference 
    2021 CPT: Complete Pocket Ophthalmic Reference
    2021 Retina Coding: Complete Reference Guide
    2021 Fundamentals of Ophthalmic Coding
    2021 CPT Professional Edition 
    2021 HCPCS Level ll Professional Edition
    2021 Coding Assistant: Cataract and Anterior Segment
    2021 Coding Assistant: Cornea
    2021 Coding Assistant: Glaucoma
    2021 Coding Assistant: Oculofacial
    2021 Coding Assistant: Pediatrics/Strabismus
    2021 Coding Assistant for Subspecialties 
    Recorded Webinar: 2021 Ophthalmology Coding Update
    Webinar: 2021 Ophthalmology Coding Update
    Ophthalmology Journal
    Ophthalmology Retina Journal
    Focal Points Member Benefit
    2021 ICD-10-CM for Ophthalmology: The Complete Reference 
    Conquering New E-M Documentation Guidelines for Ophthalmology
    2020-2021 Basic and Clinical Science Course Complete Set
    2020-2021 Basic and Clinical Science Course Residency Set
    2020-2021 Basic and Clinical Science Course, Section 01: Update on General Medicine
    2020-2021 Basic and Clinical Science Course, Section 02: Fundamentals and Principles of Ophthalmology
    2020-2021 Basic and Clinical Science Course, Section 03: Clinical Optics
    2020-2021 Basic and Clinical Science Course, Section 04: Ophthalmic Pathology and Intraocular Tumors
 
  • Contact Us
  • About the Academy
  • Jobs at the Academy
  • Financial Relationships with Industry
  • Medical Disclaimer
  • Privacy Policy
  • Terms of Service
  • Help
  • For Advertisers
  • For Media
  • Ophthalmology Job Center

OUR SITES

  • EyeWiki
  • International Society of Refractive Surgery

FOLLOW THE ACADEMY

Medical Professionals

  • Facebook
  • Twitter
  • LinkedIn
  • YouTube

Public & Patients

  • Facebook
  • Twitter
  • Instagram
  • YouTube

Museum of the Eye

  • Facebook
  • Twitter
  • Instagram
  • Trip Advisor
  • Yelp
© American Academy of Ophthalmology 2021