Ocular Melanoma

January 15, 2024

3 min read

Ocular melanoma is an extremely rare type of cancer that affects adults. The aggressive cancer forms in the melanin-producing cells (melanocytes) in the eye. Melanocytes produce melanin, a pigment that gives color to the skin, eyes, and hair.

Ocular melanoma can affect parts of the eye, including:

Choroid
Iris
Ciliary body
Orbit
Conjunctiva
Eyelid

The cancer usually forms in the part of the eye that is not visible, making it extremely difficult to diagnose. Ocular melanoma is a primary cancer that arises in the eye. It can spread or metastasize in another part of the body, like the liver.

Ocular melanoma typically arises in the uveal tract, the pigmented layer of tissue found in the eye’s middle layer.The uvea is located below the white part of the eye (sclera) and contains the iris, the colored part of the eye.

Ocular melanoma causes

Even though the exact causes of ocular melanoma are unknown, experts link the occurrence of the disease to its risk factors.

Some of the common risk factors for developing ocular melanoma are:

Being Caucasian
Light skin and eye color
Older age
Men being slightly more susceptible than women
Inherited skin problems like dysplastic nevus syndrome that cause abnormal moles
Exposure to UV lights from the sun or artificial sunlight from tanning beds
Abnormal skin pigmentation or freckles in the eye/ eyelids
Abnormal moles in the eyes

Ocular melanoma symptoms

Ocular melanoma may not show symptoms at first. Even when the symptoms appear, they may mimic less serious eye conditions.

Some of the symptoms of eye melanoma are:

Eyes that bulge
Growing dark spot on the iris
Changes in the shape or size of the iris
Sensations of small spots or “floaters” or flashing lights in your vision
Vision problems like poor or blurry vision or losing part of the field of vision
Changes in eyeball position or its movement in the socket
Loss of peripheral vision

Eye melanoma can have complications like vision loss or glaucoma.

Ocular melanoma diagnosis

Ocular melanoma can be diagnosed during a routine eye exam, especially when you have symptoms. If your eye doctor suspects eye cancer, they may recommend the following tests.

Eye ultrasound: A procedure where high-frequency sound waves are bounced off the internal tissues of the eye, producing eye images.
Fluorescein angiography: A procedure where a dye is injected into the arm that travels into the eye. A specialized camera then takes pictures of the internal eye to locate leakages, blockages, or other abnormalities.
Optical coherence tomography (OCT): An imaging test that takes a detailed picture of the inside of the eye.
Biopsy: When conjunctival melanoma is suspected, your ophthalmologist may perform a biopsy. The procedure requires extracting a tissue sample from the eye surface, which is then tested in the laboratory.

Ocular melanoma treatment

The treatment of ocular melanoma will depend on:

The size and location of the melanoma
Your overall health

Eye cancer treatment usually focuses on destroying the cancer cells, saving the eye, and preserving the vision as much as possible.

Ocular melanoma treatment may include:

Radiation therapy

Eye cancer is usually treated with plaque radiation therapy, where radioactive seeds are attached to a disk or plaque, which is then placed on the eye wall next to the tumor.

Radiation therapy can also be done by a machine that directs radioactive particles to the eye. Smaller tumors can be treated with treatments involving laser or heat energy.

Surgery

For larger tumors, tumors that cause eye pain, or where tumors involve optic nerves, surgery may be recommended. The surgery may remove the entire eye (enucleation) and put an implant in place.

Both radiation and surgery can affect your vision.

For conjunctival melanoma (melanoma in the eye surface), treatment may include radiation, chemotherapy, surgery, eye drops, and freezing treatment.