What is eye melanoma?
Melanoma is a type of cancer that develops in the cells that produce melanin — the pigment that gives your skin its color. Your eyes also have melanin-producing cells and can develop melanoma. Eye melanoma is also called ocular melanoma.
Most eye melanomas form in the part of the eye you can’t see when looking in a mirror. This makes eye melanoma difficult to detect. In addition, eye melanoma typically doesn’t cause early signs or symptoms.
Treatment is available for eye melanomas. Treatment for some small eye melanomas may not interfere with your vision. However, treatment for large eye melanomas typically causes some vision loss.
How common is eye melanoma?
Eye melanoma is the most common primary eye tumor in adults and the 2nd most common melanoma (after cutaneous melanoma) with around 2,000 new cases diagnosed each year in the United States. Please discuss with your doctor for further information.
What are the symptoms of eye melanoma?
The common symptoms of eye melanoma are:
- A growing dark spot on the iris
- A sensation of flashing lights
- A change in the shape of the dark circle (pupil) at the center of your eye
- Poor or blurry vision in one eye
- Loss of peripheral vision
- Sensation of flashes and specks of dust in your vision (floaters)
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes eye melanoma?
It is not clear why eye melanomas develop. Researchers have discovered that certain gene mutations are more commonly found in patients who have melanoma. This suggests that there is a strong genetic component to the disease.
Eye melanoma occurs when the DNA of healthy eye cells develop errors. These errors cause the cells to multiply out of control. The mutated cells collect in the eye and form a melanoma.
What increases my risk for eye melanoma?
There are many risk factors for eye melanoma, such as:
- Exposure to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time
- Having light-colored eyes (blue or green eyes)
- Older age
- Caucasian descent
- Having certain inherited skin conditions, such as dysplastic nevus syndrome, that cause abnormal moles; and
- Having abnormal skin pigmentation involving the eyelids and increased pigmentation on the uvea
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is eye melanoma diagnosed?
To diagnose eye melanoma, your doctor may recommend:
- Eye exam. Your doctor will examine the outside of your eye, looking for enlarged blood vessels that can indicate a tumor inside your eye. Then, with the help of instruments, your doctor will look inside your eye.
One method, called ophthalmoscopy, uses lenses and a bright light mounted on your doctor’s forehead — a bit like a miner’s lamp. Another method, called slit-lamp biomicroscopy, uses a microscope that produces an intense beam of light to illuminate the interior of your eye.
- Eye ultrasound. An eye ultrasound uses high-frequency sound waves from a hand-held, wand-like apparatus called a transducer to produce images of your eye. The transducer is placed on your closed eyelid or on the front surface of your eye.
Imaging of the blood vessels in and around the tumor (angiogram). During an angiogram of your eye, a colored dye is injected into a vein in your arm. The dye travels to the blood vessels in your eye.
A camera with special filters to detect the dye takes flash pictures every few seconds for several minutes.
- Removing a sample of suspicious tissue for testing. In some cases, your doctor may recommend a procedure to remove a sample of tissue (biopsy) from your eye.
To remove the sample, a thin needle is inserted into your eye and used to extract suspicious tissue. The tissue is tested in a laboratory to determine whether it contains eye melanoma cells.
An eye biopsy isn’t usually necessary to diagnose eye melanoma.
Determining whether cancer has spread
Your doctor may also recommend additional tests and procedures to determine whether the melanoma has spread (metastasized) to other parts of your body. Tests may include:
- Blood tests to measure liver function
- Chest X-ray
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Abdominal ultrasound
How is eye melanoma treated?
Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your overall health and your preferences.
Waiting to treat small eye melanomas
A small eye melanoma may not require immediate treatment. If the melanoma is small and isn’t growing, you and your doctor may choose to wait and watch for signs of growth.
If the melanoma grows or causes complications, you may choose to undergo treatment at that time.
Operations used to treat eye melanoma include procedures to remove part of the eye or a procedure to remove the entire eye. Options may include:
- Surgery to remove the melanoma and a small area of healthy tissue. Surgery to remove the melanoma and a band of healthy tissue that surrounds it may be an option for treating small melanomas.
What procedure you’ll undergo depends on the size and location of your eye melanoma. For instance, surgery to remove a small melanoma affecting the iris is called iridectomy. Surgery to remove a melanoma in the choroid is called choroidectomy.
- Surgery to remove the entire eye (enucleation). Enucleation is often used for large eye tumors. It may also be used if the tumor is causing eye pain.
After the eye with melanoma is removed, an implant is inserted into the same position, and the muscles controlling movement of the eye are attached to the implant, which allows the implant to move.
After you’ve had some time to heal, an artificial eye (prosthesis) is made. The front surface of your new eye will be custom painted to match your existing eye.
Radiation therapy uses high-powered energy beams, such as protons or gamma rays, to kill cancer cells. Radiation therapy is typically used for small to medium-sized eye melanomas.
The radiation is usually delivered to the tumor by placing a radioactive plaque on your eye, directly over the tumor in a procedure called brachytherapy. The plaque is held in place with temporary stitches. The plaque looks similar to a bottle cap and contains several radioactive seeds. The plaque remains in place for four to five days before it’s removed.
The radiation can also come from a machine that directs radiation, such as proton beams, to your eye (external beam radiation or teletherapy). This type of radiation therapy is often administered over several days.
Treatment that uses a laser to kill the melanoma cells may be an option in certain situations. One type of laser treatment, called thermotherapy, uses an infrared laser and is sometimes used in combination with radiation therapy.
Extreme cold (cryotherapy) may be used to destroy melanoma cells in some small eye melanomas, but this treatment isn’t commonly used.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage eye melanoma?
The following lifestyles and home remedies might help you cope with eye melanoma:
If your cancer treatment causes total loss of vision in one eye, such as happens when an eye is removed, it’s still possible to do most things you were able to do with two working eyes. But it may take a few months to adjust to your new vision.
Having only one eye affects your ability to judge distance. And it may be more difficult to be aware of things around you, especially things occurring on the side without vision.
Ask your doctor for a referral to a support group or an occupational therapist, who can help devise strategies for coping with and adjusting to your altered vision.
If you have any questions, please consult with your doctor to better understand the best solution for you.
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