Ocular Melanoma

Ocular melanoma (eye melanoma) is a type of eye cancer that forms on or inside your eye.

Most people think of skin cancer with melanoma. And that’s where it’s most common. But it can develop in any of your cells that produce the pigment melanin. That includes cells in your eyes.

Ocular melanoma can be fatal. But it’s treatable. If a healthcare provider catches it early, it may be curable.

Types of ocular melanoma

Healthcare providers classify ocular melanoma in a few ways.

Your provider might use a more specific name to classify where in your eye the cancer is:

• Conjunctival melanoma: This is when the cancerous cells are in the clear membrane that covers the white part of your eye and the inside of your eyelid.
• Uveal melanoma: The uvea is the middle layer of your eye. Cancer can grow or spread there. Your provider may also call this intraocular melanoma.

The three subtypes of uveal melanoma include specific parts of your eye in your uvea:

• Iris melanoma: This is melanoma in the colored part of your eye.
• Choroid melanoma: The choroid supplies blood to other parts of your eye.
• Ciliary body melanoma: This is melanoma in the part of your eye that makes the fluid that fills your eye and helps focus your eye’s lens.

Symptoms of ocular melanoma

Symptoms of eye melanoma can include:

• Blurry vision
• Blind spots in your vision that get bigger over time
• Other visual field defects
• Eye flashes
• Eye pain
• Feeling extra pressure in or around your eye

You might be able to see changes in your eyes, including:

• Redness or irritation
• Eye freckles
• Dark spots in your eyes that develop or change quickly

Many of the early signs of ocular melanoma are things you can’t see or notice yourself. An eye doctor can see them inside your eyes. That’s why it’s important to get regular eye exams, even if you don’t wear glasses or contacts.

Eye melanoma causes

Ocular melanoma happens when cells that make melanin pigment change (mutate) and multiply in ways they shouldn’t. These cells create cancerous tumors. Experts aren’t always sure why melanoma develops. But you may have a higher risk if you:

• Are white
• Have lighter skin
• Have light colored eyes
• Have a biological family history of melanoma

Complications of this condition

Complications of ocular melanoma can include:

• Metastasis: This is the medical term for cancer spreading. Primary ocular melanoma spreads to other parts of the body in about half of all cases.
• Vision loss: The cancer can permanently damage your eyes and vision. Some of the treatments for eye melanoma can cause vision loss as a side effect. You may need surgery to remove tissue from your eye. This might affect your vision, even after you recover.
• Other eye issues: Having eye melanoma increases your risk of conditions like glaucoma and cataracts. It can also cause new refractive errors that affect your vision.

Ocular melanoma can be fatal, even with treatment. This is especially true if it’s metastatic.

How doctors diagnose eye melanoma

An eye doctor will diagnose ocular melanoma with an eye exam and some tests. They’ll look inside your eyes and check your vision. A slit lamp exam can show signs of cancer, even if it’s early.

Tell your eye doctor if you’ve noticed any symptoms. Let them know if anyone in your biological family has had melanoma before.

Your eye doctor might order other imaging tests if they see any signs of melanoma in your eyes. You may need:

• Fluorescein angiography
• Ultrasound
• Optical coherence tomography
• A CT scan or an MRI to see if there are cancer cells anywhere else in your body

Your eye doctor may use a fine-needle aspiration or biopsy to take a sample of any growths or tumors in your eyes. Healthcare providers will use these tissue samples to confirm that it’s ocular melanoma.

You’ll need to meet with a cancer doctor to stage the cancer and start treatments.

How is eye melanoma treated?

Ocular melanoma is treatable. In some cases, it’s curable. The most common treatments include:

• Surgery: A surgeon will remove some or all of your eye. This can help prevent the cancer from spreading.
• Radiation therapy: This shrinks tumors and kills cancer cells.

What can I expect if I have ocular melanoma?

It’s tough to predict one outlook that applies to everyone. Every case of eye melanoma is different. What you can expect depends on several factors, including:

• Which type you have
• How early it was diagnosed
• The size and location of tumors
• How well it responds to treatment

Your cancer care team will help you understand everything you need to know. Caring for your overall physical and mental health is also important. Cancer survivorship starts when you get your diagnosis. Survivorship programs and organizations can help you access resources and care, including mental health support. Ask your care team about resources in your area or online that can help.

Ocular melanoma survival rates

Healthcare providers usually refer to a five-year survival rate for cancers. This means the percentage of people with that cancer who survive at least five years after diagnosis.

Most people with eye melanoma that doesn’t spread survive at least five years. Talk to your providers about what to expect.

All survival rates are based on averages from lots of people. They’re just an estimate. And they can’t take the specifics of your life, body and health into account. Your cancer care team will help you set realistic goals and expectations.