Noninvasive imaging for the diagnosis of melanocytic conjunctival tumor

Introduction: Ophthalmologists usually evaluate melanocytic conjunctival tumor on clinical and slit-lamp examination and perform biopsies in cases of malignancy suspicion. However, differential diagnosis can be challenging with the consequence that many benign lesions are excised in suspicion of malignancy and that conjunctival melanoma can be underdiagnosed in an early phase of growth. New noninvasive imaging techniques are under development and can play a role in helping the clinical diagnosis of melanocytic conjunctival tumors. Areas covered: We review the current literature about new noninvasive imaging techniques for the diagnosis of conjunctival tumors with attention to dermoscopy, in vivo reflectance confocal microscopy (RCM), optical coherence tomography and ultrasound biomicroscopy. Expert opinion: In the author's opinion these new techniques are particularly useful for the diagnosis of melanocytic conjunctival tumor and they probably will increase their diffusion in ophthalmology in the next years, especially dermoscopy and handheld RCM.