The conjunctival nevus is one of the most common benign tumors of the ocular surface. Melanomas are rare; they can arise without a preexisting conjunctival nevus, or due to malignant transformation in case of PAM (primary acquired melanosis). The retrospective study analyzed 70 patients with pigmented lesion of the conjunctiva in period 1996-2006 at the Department of Ophthalmology, Faculty of Medicine, Comenius University, Bratislava, with the aim to determine the frequency of change in size and pigmentation of these benign lesions. Epibulbar pigmented lesions are rare, recognition of their precursors lesions at an early stage is important. Surgical excision is usually effective in eradicating these lesions. Extensive cases of flat primary acquired melanosis with atypia may be managed with mitomycin C. Multifocal and advanced melanoma, especially showing intraocular or orbital invasion, may require exenteration and/or radiotherapy to adequately extirpate the neoplasm locally. However, systemic metastases might have already develop in patients with advanced stage of disease (Fig. 7, Ref 13). Full Text (Free, PDF) www.bmj.sk.