Understanding Scleral Melanocytosis, A Benign Pigmented Eye Condition. An overabundance of melanocytes in the episcleral tissues causes scleral melanocytosis, a benign pigmentation of the sclera. This condition is generally congenital and more common in people of Asian or African descent. Characteristics Appearance: Scleral melanocytosis appears as bluish-gray or slate-colored patches on the white part of the eye (sclera). These patches are normally present from birth and do not progress. Unilateral or bilateral: It can affect one or both eyes; however, bilateral presentation is more common. Causes This disease results from an excess of melanocytes during embryonic development. It is generally harmless and not associated with systemic diseases. Differentiation from Similar Conditions. Scleral melanocytosis is different from ocular and primary acquired melanosis, which can go on to cancer. Unlike these disorders, scleral melanocytosis is entirely benign. Management No therapy is necessary. Scleral melanocytosis is a benign disorder that does not require medical or surgical intervention. Cosmetic Considerations People rarely seek assistance for cosmetic reasons. We recommend regular eye exams to rule out other ocular disorders, even if the symptoms are mild. This innocuous illness is a crucial differential diagnosis forpigmented eye lesions and requires no treatment other than reassurance.