Eye Freckle (Nevus)

What are eye freckles?

Eye freckles, also called nevi, are colored growths on the surface of the eye. You can have nevi in or outside of your eye. Nevus is the word for a single freckle. On the skin, nevus is another word for mole.

Nevi that you’re born with are typically harmless. Nevi that develop during your lifetime are probably harmless, too. However, your healthcare provider will want to monitor eye freckles during your eye exams. Some of them have the potential to turn into cancer (melanoma).

Usually, you’ll only have a nevus in one eye.

Are there different types of nevi?

Yes, there are different types of nevi based on where the nevus appears.

Conjunctival nevus

The location for this type of eye freckle, or nevus, is the conjunctiva, which is the clear film that covers the front of your eyes and the insides of your eyelids. The nevus ranges in color from yellow to gray to brown. It usually shows up because it appears on the sclera, or the white of your eye.

Conjunctival nevi are the common type of visible spots on the eye.

Iris nevus and iris freckle

An iris nevus and iris freckle both appear in the iris, or the colored part of your eye. The main differences between the iris nevus and the iris freckle are size and depth.

An iris nevus is larger than an iris freckle. However, an iris nevus goes deeper into the layers of the iris and sometimes can pull the pupil to the side.

Choroidal nevus

A choroidal nevus is a freckle located on the back or inner part of your eye. The choroid is part of the uvea, which is the pigmented part of your eye and includes the iris. The choroid falls between the sclera and the cornea. There’s such a thing as an amelanotic choroidal nevus, which simply means that the spot is very light in color.

Both choroidal nevi and iris nevi are forms of uveal nevi.

How common is this condition?

Having an eye freckle (nevus) isn’t rare. An estimated 1 in 10 people have freckles in their eyes. The condition seems to happen more often in white people, but that may be due to freckles showing up more easily on lighter eye colors.

What are the signs and symptoms of an eye freckle?

You can usually see an eye freckle. They’re easier to see when they’re on the white part of your eye, but you can often see them in the iris, especially in eyes that are lighter in color. Benign (noncancerous) spots normally don’t cause any trouble for you.

However, there could be other issues if you have a freckle and you have symptoms such as:

• Changes in your vision, including blurry vision.
• Eye floaters.
• Eye pain or discomfort that may seem like a headache.
• Changes in the size or color of the freckle.

Eye floaters and changes in your vision, such as darkened side vision, can be symptoms of retinal detachment. Choroidal nevi can sometimes leak fluid or result in new and abnormal blood vessels, which can lead to retinal detachment.

What causes an eye freckle?

Eye freckles happen when a group of melanocytes (pigment cells) group together. These cells produce melanin, which is the substance that gives your eyes, hair and skin their color.

Some eye freckles can be hereditary, caused by genetic conditions. Others may happen because of exposure to the sun in the same way that freckles on your skin can come out after you’ve been out in the sun.

How is an eye freckle (nevus) diagnosed?

Your eye care provider can see some types of eye freckles even without an eye exam. However, you’ll need an exam to find a choroidal nevus.

How is an eye freckle treated?

Most eye freckles (nevi) aren’t dangerous, but your provider will monitor them during your regular eye exams and document them with photos and other imaging methods. Removing a nevus when it’s not necessary could do more harm than good.

In general, your provider won’t treat eye freckles unless they think that the spots may be malignant (cancerous). If your provider thinks the spot is cancerous, they may recommend that you have the nevus removed through surgery, radiation or laser surgery. They may also recommend that they monitor the spot.

How can I reduce my risk of developing eye freckles?

You can’t prevent getting an eye freckle that’s congenital (that you’re born with). You may be able to reduce your risk as you get older by taking care to keep your eyes protected from sunlight.

What can I expect if I have an eye freckle?

If you have a freckle on your eye, your outlook is typically very good. Most eye freckles are harmless and will have no effect on your vision.

How do I take care of myself if I have an eye freckle?

It’s important to get regular eye examinations whether or not you have a freckle in your eye. It’s also important to wear sunglasses that protect against ultraviolet rays. Always wear safety glasses when you’re working.

Contact your healthcare provider if you have any changes in vision or any discomfort in your eyes.

What is the difference between choroidal nevus or iris nevus and melanoma?

The difference between melanoma and types of nevi is that melanoma is cancer. About 1 in 8,000 people who have a uveal nevus will find that the freckle becomes cancerous. Most nevi remain benign (not cancerous).

A note from Cleveland Clinic

If you have an eye freckle, you’ve probably asked yourself if it’s dangerous or if you need to worry about it. You may even have asked your healthcare provider, or want to ask them about the freckle. In the majority of cases, the answer is that an eye freckle, or nevus, isn’t dangerous. However, you should make a point of seeing your eye care provider regularly because there are some types of freckles that can become cancerous.