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Eye melanoma

Medically reviewed by Drugs.com. Last updated on Aug 9, 2022.

Overview

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.

Where eye melanoma occurs

Eye melanoma most often affects the middle layer of your eye (uvea). Parts of your eye's uvea that can develop melanoma include the colored portion of your eye (iris), the muscle fibers around your eye's lens (ciliary body), and the layer of blood vessels that lines the back of your eye (choroid).

Symptoms

Eye melanoma may not cause signs and symptoms. When they do occur, signs and symptoms of eye melanoma can include:

When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you. Sudden changes in your vision signal an emergency, so seek immediate care in those situations.

Causes

It's not clear what causes eye melanoma.

Doctors know that eye melanoma occurs when errors develop in the DNA of healthy eye cells. The DNA errors tell the cells to grow and multiply out of control, so the mutated cells go on living when they would normally die. The mutated cells accumulate in the eye and form an eye melanoma.

Where eye melanoma occurs

Eye melanoma most commonly develops in the cells of the middle layer of your eye (uvea). The uvea has three parts and each can be affected by eye melanoma:

Eye melanoma can also occur on the outermost layer on the front of the eye (conjunctiva), in the socket that surrounds the eyeball and on the eyelid, though these types of eye melanoma are very rare.

Risk factors

Risk factors for primary melanoma of the eye include:

Complications

Complications of eye melanoma may include:

Diagnosis

To diagnose eye melanoma, your doctor may recommend:

Determining whether cancer has spread

Your doctor may recommend additional tests and procedures to determine whether the melanoma has spread (metastasized) to other parts of your body. Tests may include:

Treatment

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.

Radiation therapy

Radiation therapy uses high-powered energy, 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.

Laser treatment

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.

Photodynamic therapy

Photodynamic therapy combines medications with a special wavelength of light. The medicine makes the cancer cells vulnerable to light. The treatment damages the vessels and the cells that make up the eye melanoma. Photodynamic therapy is used in smaller tumors, as it isn't effective for larger cancers.

Cold treatments

Extreme cold (cryotherapy) may be used to destroy melanoma cells in some small eye melanomas, but this treatment isn't commonly used.

Surgery

Operations used to treat eye melanoma include procedures to remove part of the eye or a procedure to remove the entire eye. What procedure you'll undergo depends on the size and location of your eye melanoma. Options may include:

Coping and support

Coping with vision changes

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.

Preparing for an appointment

Start by seeing your family doctor if you have any signs or symptoms that worry you. If your doctor suspects you have an eye problem, you may be referred to an eye specialist (ophthalmologist).

If you have eye melanoma, you may be referred to an eye surgeon who specializes in treating eye melanoma. This specialist can explain your treatment options and may refer you to other specialists depending on the treatments you choose.

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well-prepared. Here's some information to help you get ready, and what to expect from your doctor.

What you can do

Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For eye melanoma, some basic questions to ask your doctor include:

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover other points you want to address. Your doctor may ask:

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