Pigment spots in the sclera or episclera may be caued by a number of factors.
Melanin-related conditions associated with pigment spots of the sclera or episclera:
(1) acquired melanosis
(2) nevus
(3) malignant melanoma
(4) migration of uveal melanocytes
(5) intrascleral nerve loops with uveal pigment
Other conditions associated with pigment spots of the sclera or episclera:
(1) cyst
(2) staphyloma
(3) drugs
(4) foreign body
(5) hemosiderin from resolving hemorrhage
(6) transcleral migration of pigment following cryotherapy of intraocular tumor or trauma
(7) ochronosis (alkaptonuria or acquired)
