Eye Health More Eye Issues & Safety An Overview of Choroidal Nevus What it means to have a freckle in the eye By Troy Bedinghaus, OD Troy Bedinghaus, OD LinkedIn Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association. Learn about our editorial process Updated on December 05, 2020 Medically reviewed by Johnstone M. Kim, MD Medically reviewed by Johnstone M. Kim, MD on April 11, 2020 Johnstone M. Kim, MD, is board-certified in ophthalmology. He's a practicing physician at Midwest Retina in Dublin, Ohio and previously served as a full-time faculty member at the Wayne State University School of Medicine and the Kresge Eye Institute in Detroit, Michigan. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Choroidal Nevus Symptoms Treatment Possible Complications You've just completed your annual eye exam and your doctor 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. Verywell / Jessica Olah 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 doctor 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. If you have a nevus, then your doctor may want to see you every three to six months for the first year or two when first identified. They will want to keep a close eye on possible changes. 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 doctor will then schedule you to come back in three to six months to look for possible changes. If your doctor 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 doctor 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. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Ocular Melanoma Foundation. Understanding choroidal nevi. New York Eye Cancer Center. Choroidal nevus. Additional Reading Sowka, Joseph W. OD, FAAO, Andrew S. Gurwood, OD, FAAO, and Alan G. Kabat, OD, FAAO. Handbook of Ocular Disease Management, Choroidal Nevus. 2000-2001.