Current RMA Instruments
| Reasonable Hypothesis SOP | 27 of 2018 as amended |
| Balance of Probabilities SOP | 28 of 2018 as amended |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 190.0, 190.3-190.6, 190.8, 190.9
- ICD-10-AM Codes: C69.0-C69.4, C69.8, C69.9
Brief description
This SOP covers primary cancers of the eyeball and conjunctiva. Primary means that the cancer arose in the eye and did not arrive secondarily from another body site.
Confirming the diagnosis
Information on histology (from biopsy or surgery) is required to confirm the diagnosis and apply the SOP. There are SOP factors specific to site and tumour type, including factors specific to the subtype of melanoma (uveal or conjunctival), so precise information will be required to apply those factors.
The relevant medical specialist is an ophthalmologist.
Additional diagnoses covered by SOP
- Carcinoma of the conjunctiva
- Carcinoma of the cornea
- Malignant melanoma of the choroid, ciliary body or iris (uveal tract)
- Malignant melanoma of the conjunctiva
Conditions excluded from SOP
- Hodgkin’s lymphoma of the eye*
- malignant neoplasm of the lacrimal duct#
- malignant neoplasm of the lacrimal gland#
- malignant neoplasm of the optic nerve#
- malignant neoplasm of the orbit* - malignant neoplasm of bone or articualr cartilage SOP
- malignant neoplasm of the skin of the eyelid*
- non-Hodgkin lymphoma of the eye*
- Retinoblastoma#
- Secondary carcinoma involving the eye – code to primary site.
- soft tissue sarcoma of the eye*
- soft tissue sarcoma of the eyelid*
* another SOP applies
# non-SOP condition
Clinical onset
The clinical presentation is variable. There may be a lump noticed on the surface of the eye or impairment of visual acuity or visual field. The condition may be found incidentally on routine examination.
Clinical worsening
The only SOP worsening factor is for inability to obtain appropriate clinical management. Appropriate management can vary substantially with each case.