Intraocular melanoma is the most common type of eye cancer in adults. It affects the uvea, or middle part of the eye. It can lead to vision loss and changes in eye color or shape. Intraocular melanoma can spread to other areas of the body, especially the liver. Treatments include surgery and radiation therapy.
Intraocular melanoma is a rare cancer that forms inside the eye. It causes melanocytes (cells that produce pigment, or color) to grow out of control. The disease can lead to vision changes or loss.
Intraocular melanoma usually affects the middle part of the eye called the uvea. The uvea is between the sclera (outer white part of the eye) and the retina (inner part of the eye that processes light and controls vision).
Intraocular melanoma is also called uveal melanoma. It can form in any of the three parts of the uvea:
This type of eye cancer usually starts in the choroid. It can metastasize (spread) from the uvea to other parts of the body, usually the liver.
Intraocular melanoma affects the same types of cells as skin melanoma, but they’re different conditions.
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Some vision loss is common with intraocular melanoma. The amount of vision loss depends on the size of the melanoma and how long you have had it. Long-standing eye melanomas may cause complete loss of vision.
The following risk factors make you more likely to develop eye melanoma:
Intraocular melanoma is the most common type of eye cancer in adults. But the condition is very rare. Healthcare providers diagnose about 2,500 people in the U.S. with intraocular melanoma each year.
Genes, which are made of DNA, give instruction to cells about how to multiply. But if a gene mutates (changes), it might allow cells to multiply out of control. That leads to cancer.
With intraocular melanoma, mutated DNA give the wrong instructions to melanocytes in the eye. The melanocytes grow and form tumors.
In some cases, intraocular melanoma may not cause symptoms. Or symptoms may be difficult to spot since the cancer is in part of the eye that isn’t visible.
When symptoms do occur, they can include:
Your healthcare provider evaluates your symptoms and reviews your medical history. During an eye exam, your provider checks your vision and looks at the inside of your eye. They may dilate (enlarge) your pupils with special eye drops. This helps your provider see structures at the back of your eye.
Other tests may include:
If your provider diagnoses you with eye melanoma, they may do more imaging or blood tests. These tests help your provider stage the cancer. Staging is the process of finding out if the cancer has spread from your eye to other areas of your body.
If an eye tumor isn’t causing symptoms or vision loss, and is small in size (less than 2.5 mm in thickness) you may not need treatment right away. Your healthcare provider may suggest “watchful waiting” and monitor your condition for tumor growth prior to recommending treatment.
If you do need treatment, the most common treatments are radiation therapy or surgery. Your treatment plan depends on:
There are several types of surgery for intraocular melanoma:
Some degree of vision loss is a risk with each type of surgery. You may choose to have a prosthetic (artificial) eye after enucleation or exenteration, but this won’t restore vision in that eye.
Other treatments for intraocular melanoma include:
Most risk factors for intraocular melanoma, such as age and race, aren’t controllable. But you can reduce your risk by visiting an ophthalmologist (a healthcare provider specializing in eye care) for regular eye exams.
Research shows that intraocular melanoma spreads to other parts of the body in about 40% to 50% of cases. In about 90% of those cases, the cancer spreads to the liver. Choroid melanoma and ciliary body melanoma are more likely to spread than iris melanoma. Like all cancers, the outlook is better when healthcare providers catch and treat the tumor early.
Stay in communication with your healthcare provider and monitor the intraocular melanoma closely. You may need periodic liver imaging exams to find out if the cancer has spread.
If you have intraocular melanoma, you may want to ask your provider:
A note from Cleveland Clinic
Intraocular melanoma is cancer inside the eye. It affects cells in the uvea, or the middle part of the eye. Symptoms can include vision loss or changes to the shape and appearance of the eye. Intraocular melanoma can spread to other parts of the body such as the liver. The most common treatments are radiation therapy and surgery.
Last reviewed by a Cleveland Clinic medical professional on 04/23/2021.
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