Eye melanoma is a type of cancer that develops in pigment-producing cells. These pigments give color to the skin, hair, and eyes. Just as you can develop melanoma on your skin, you can also develop it in your eyes or conjunctiva. Melanoma of the eye is also known as ocular melanoma.
Most ocular melanomas form in parts of the eye that you can’t see in the mirror. This complicates the detection of ocular melanoma. In addition, eye melanoma usually does not cause early signs or symptoms.
Melanoma of the eye may not cause any signs and symptoms. When they occur, signs and symptoms of ocular melanoma may include:
A sensation of lightning or dust in your vision (floating)
Grows dark spots on the iris
Changes in the shape of the dark circle (pupil) in the center of the eye.
Poor or blurred vision in one eye
Loss of peripheral vision
What causes melanoma of the eye?
Ocular melanoma occurs when the pigment-producing cells in the eye divide and multiply too quickly. This creates a lump of tissue known as a tumor.
It’s not clear why this happens, but the following factors can increase the risk:
Lighter eye color – if you have blue, gray, or green eyes, you are at a higher risk of developing eye melanoma than people with brown eyes.
fair or pale skin – eye melanoma mostly affects white people and is more common in fair-skinned people
unusual moles – if you have moles that are irregular in shape or unusual in color, you are at increased risk of skin cancer and eye melanoma
Use of tanning beds – there is evidence that exposure to ultraviolet (UV) radiation, for example from tanning beds, may increase the risk of ocular melanom
Excessive sun exposure – this increases the risk of skin cancer and can also be a risk factor for eye melanoma
The risk of developing ocular melanoma also increases with age, with most cases diagnosed in people in their 50s.
Diagnosis of eye melanoma
The diagnosis of ocular melanoma begins with an examination of the dilated eyes by an ophthalmologist. Because ocular melanoma does not initially cause any symptoms, it is often detected during routine eye exams.
Melanoma is different from a nevus or birthmark in or on the eye. Melanoma in the eye can vary in color, from dark to light brown, orange, or colorless. They are thicker than normal and may ooze.
If your eye doctor suspects you have ocular melanoma, he or she may recommend further testing. This can include:
Ultrasound scan of your eye – a small probe placed over your closed eye uses high-frequency sound waves to create pictures of the inside of your eye; This allows your doctor to learn more about the location of the tumor and its size
Fluorescein angiogram – this involves taking pictures of the suspected cancer using a special camera after the dye is injected into your bloodstream to highlight the tumor
Sometimes a thin needle can be used to take a small sample of tumor cells (biopsy).
The genetic information in these cells is analyzed to indicate the possibility of cancer spreading or returning.
Ocular melanoma treatment
Treatment for eye melanoma depends on the size and location of the tumor.
The main treatments for ocular melanoma are:
Brachytherapy – a small plate coated with radioactive material, called plaque, is placed near the tumor and left there for a week to kill cancer cells.
External beam radiation therapy – a machine is used to gently direct a beam of radiation at the tumor to kill cancer cells
Surgery to remove the tumor or part of the eye – this can be done if the tumor is small and you still have some vision in your eye
Removal of the eye (enucleation) – this may be necessary if the tumor is large or you have lost your vision; the eye is finally replaced with an artificial eye that matches your other eye
Chemotherapy is infrequently used for eye melanoma but may be apt for other types of eye cancer.