Precautionary note on retrobulbar alcohol injections.

been reported in the world literature.4 The cutaneous pigmentation commonly involves the ophthalmic, maxillary, and occasionally the mandibular division of the trigeminal nerve. Oculodermal melanocytosis occurs most often in orientals and blacks and is rarely seen in the white population.2 5-7 In contrast, malignant melanoma transformation associated with ODM and OM is known to occur more often in whites and rarely among blacks and orientals.5 7-9 The rarity of black patients reported with ODM and choroidal melanoma is supported by only two previous case reports: Nik et al7 reported a case of a 44-year-old black woman with a mixed cell type melanoma and ODM. Velazquez9 reported a 40-year-old black woman with bilateral ODM with a mixed cell malignant melanoma occurring in the more heavily pigmented eye (right eye). Diagnosis ofODM in a black patient may be difficult. The dermal pigment may be difficult to detect because of the dark skin pigmentation and the ocular involvement may be confused with racial melanosis. In a situation with unilateral hyperpigmentation of the ocular tissues, the discrepancy between racial melanosis may be easier. With careful history and physical examination, the dermal pigment may be noticed.