Pigmented/non-pigmented lesions on the eye

The following information provides a guide for GPs on how to manage or make a referral for presentation of Pigmented/non-pigmented lesions on the eye in children.

GP Management

Provide re-assurance:

Racial melanosis is common in people with dark skin:
flat and slate grey or flecks of brown, often more noticeable in lower sclera. May get more noticeable over time, but as children grow up, they may also get less obvious, as the sclera thickens.
If bilateral and typical in appearance, or unilateral and mild (as described here), hospital referral is not required. If unilateral and very marked, especially ir iris is darker or eyelid pigmented on that side, refer routinely.

Conjunctival naevus or papilloma can be monitored: by annual review during sight test by community optometrist or by the family, for two to five years, to make sure the lesion is not significantly increasing in size and to reassure the family. However malignant lesions on the white of a child’s eye are extremely rare in the UK and nearly all lesions are benign. Most of these will grow slightly in line with growth of the child.

Referral information

• If possible, attach photo of eye to e-referral

Always include:

• Child’s date of birth
• Address
• Child’s social worker details (including Borough), if any
• Parent/carer contact phone number and email

Self-care & advice

• Take a photo of the lesion once a year, to make sure it is not increasing in size if worried
• These pigmented or pink lesions are benign in children

Further assistance

This pathway has been produced by Moorfields Eye Hospital NHS Foundation Trust to help clinicians manage the healthcare of children and young people. However, if you need to contact a paediatric clinician, please see below for contact details:

Moorfields Eye Hospital:

Paediatric helpline: 0207 2533411 extn 4569, Mon- Fri 10:00am-13:00pm then 14:00pm-16:00pm