An Overview of Choroidal Nevus

You've just completed your annual eye exam and your healthcare provider says you passed with flying colors. However, while examining the inside of your eyes, he discovered a small choroidal nevus. Although the name sounds complicated, a choroidal nevus is simply a freckle inside the eye.

What Is a Choroidal Nevus?

A choroidal nevus is the name given to a spot, freckle or mole that appears in the back of the eye. Sometimes detected during a dilated eye examination, these pigmented spots are usually flat and slate-greyish in color. Choroidal nevi are found in the choroid, a blood vessel-rich layer lying between the retina and the sclera.

Although they are not necessarily a "normal" or common finding in eyes, they may not represent anything wrong with the eye. Nevi vary from patient to patient but most look very similar and have certain traits that eye doctors are very familiar with. Your healthcare provider will document this finding in your chart if it is detected during a routine eye exam.

Symptoms of Choroidal Nevi

Most choroidal nevi do not cause symptoms. Most nevi are discovered during a routine eye examination.

If nevi grow and disrupt the surrounding tissue, they may cause fluid or blood to leak out of the tissue. If this occurs, it can cause a retinal detachment. Sometimes, people with a retinal detachment related to a nevus will complain of seeing flashes of light and/or corresponding vision loss in their field of vision.

Choroidal nevi are fairly uncommon, with an incidence of 1-2%. Many of us have retinal pigmentation variations that are more common but true choroidal nevi are fairly uncommon, especially large nevi. The best recommendation is to have annual eye examinations which include dilating the eyes with special eye drops.

Treatment

Choroidal nevi are not usually harmful. However, just like a freckle or mole on your skin, there is a potential it could evolve into melanoma. It is difficult to observe a freckle in your own eye. You should follow your eye doctor’s recommendations on when to come back or how to observe it in the future.

Photography is typically used to document the size of the choroidal nevus. Your healthcare provider will then schedule you to come back in three to six months to look for possible changes. If your healthcare provider has seen you for several years, then they may feel comfortable monitoring the nevus every 12 months.

If it appears unusual, however, you may be asked to return in a shorter period of time. Occasionally, certain diagnostic tests may be ordered, or you may be referred to a retinal specialist for a second opinion.

Possible Complications

Choroidal nevi are benign, however, your eye doctor is trained to watch closely for the development of a choroidal melanoma, a tumor found in the eye. In rare cases, the nevus must be biopsied and examined for melanoma (cancer) cells.

Choroidal melanomas are malignant tumors and must be treated. They may spread (metastasize) to other parts of your body and can be fatal. 

A Word From Verywell

If you are diagnosed with a choroidal nevus, ask your healthcare provider to give you a picture of it. Date the picture and keep it safe with your medical files. If you ever change eye doctors or have a need to see an eye specialist, it will come in very handy.

A documented picture will save your eye doctor time by providing evidence that your condition has been detected previously, has not grown, and is, most importantly, benign.