Recent Advances in the Molecular Pathogenesis and Targeted Therapy of Conjunctival Melanoma

Conjunctival melanoma (CM), a rare malignant tumor of the ocular surface, is characterized by high invasiveness and a poor prognosis. Despite aggressive local control measures such as complete surgical resection combined with cryotherapy, patients still face a high risk of local recurrence (60%) and distant metastasis (20–30%). This article provides a narrative review of the pathogenesis and targeted therapies for CM, focusing on its core molecular mechanisms, with particular attention to therapeutic strategies targeting key driver genes and pathways. It also summarizes the clinical evidence and latest breakthroughs in immunotherapy and emerging treatment strategies. By integrating evidence from basic research and clinical translation, this review provides a theoretical basis for optimizing the diagnostic and therapeutic pathways for CM.