An Overview of Eye Melanoma

Eye melanoma, or ocular melanoma, is a rare form of cancer that forms inside the uvea, the area of the eye between the retina and the white part of the eye. Most melanomas affect the skin, but sometimes a melanoma can develop in the eye. If melanoma develops inside the eye, it is called primary eye cancer. If melanoma starts in another part of the body and spreads to the eye, it is referred to as secondary eye cancer.

Symptoms

Sometimes, eye melanoma develops without any obvious signs or symptoms. Many cases of eye melanoma are discovered during a routine eye exam. Some people may develop a few symptoms including blurry vision, light flashes or dark spots in their vision. The following symptoms may be related to cancer of the eye:

• A growing dark spot on the iris of the eye
• Seeing flashes of light
• Watery, irritated eyes
• Blurry vision
• Loss of peripheral vision in one or both eyes
• Abnormal placement of the eye within the eye socket
• Development of spots and floaters
• Occasionally, pain inside or around the eye

Many of the signs and symptoms of eye melanoma are unrelated to the disease. For example, many people develop spots and floaters, especially as they age. Most eye floaters are small specks of protein called collagen that break away from the vitreous and clump together, making them visible in the line of vision. Most of the time, spots and floaters are harmless, but sometimes they are caused by certain eye diseases. Pain in or around the eye is rarely a sign of eye melanoma. If you do experience any of the symptoms of eye cancer, it's always a good idea to alert your eye healthcare provider.

Causes and Risk Factors

Healthcare providers are not sure what causes cancer of the eye. It is believed that genetics plays a role in the develop of eye melanoma. Scientists are researching certain genetic changes that may cause eye cells to become cancerous. Melanoma is a kind of cancer that develops inside the cells that give color to your eyes, skin, and hair. These types of cells create a pigment known as melanin. Melanoma usually develops in the cells of the skin, but sometimes occurs inside the eye.

As is the case with skin cancer, people with blonde or red hair, fair skin, and light-colored eyes are more likely to develop melanoma of the eye. While many skin cancers are directly related to exposure to ultraviolet rays, it is not clear if UV ray exposure is related to eye melanoma. People with a condition known as atypical mole syndrome (dysplastic nevus syndrome) seem to have a greater risk of developing melanoma of the skin as well as of the eyes. Atypical mole syndrome causes over 100 moles to appear on the body. People with this condition must be monitored closely as many of the moles develop with abnormal shapes and sizes.

Your chances of developing eye melanoma increase with the following risk factors:

• Light eye color: people with blue eyes are more likely to develop eye cancer than people with dark or brown eyes.
• Ethnic background: white, light-skinned people are more likely to develop eye melanoma than people with dark skin.
• Age: the chances of developing eye melanoma increases as you get older.
• Ultraviolet light exposure: direct exposure to UV light, including the sun, may cause an increased risk of developing certain melanomas.
• Increased mole production: people with atypical mole syndrome seem to have a greater risk of developing eye cancer.
• Genetic predisposition: some chromosomal abnormalities passed from parent to child seem to increase the risk of developing melanoma of the eye.

Keep in mind that having certain risk factors does not mean you will develop a disease, nor does having no risk factors mean that you won't develop a disease.

Diagnosis

As with other types of cancer, early detection and diagnosis of eye melanoma is crucial for establishing a successful treatment plan. A complete eye examination is helpful for your eye doctor in diagnosing the disease. A dilated eye exam (with dilated pupils) will allow your healthcare provider to see clearly into your eyes. Your practitioner will be able to look through the lens of your eye to view the health of the inner structures such as the retina and optic nerve.

The following tests may be performed while the eyes are dilated:

• Ophthalmoscopy: Your healthcare provider will use a tool called an ophthalmoscope to view the back of your eye. A magnifying lens will be used to check the retina and optic nerve.
• Slit-lamp biomicroscopy: Your practitioner will be able to view the retina, optic nerve and other parts of your eye by using a strong light and a microscope.
• Gonioscopy: This test will allow your healthcare provider to examine the front part of the eye between the cornea and the iris.

Because uveal melanoma is difficult to biopsy, treatment may be initiated without a biopsy.

Treatment Options

Treatment of eye melanoma will depend on several factors. Location, size, and type of tumor will determine which type of treatment will be most successful. Radiation therapy may be used to locate and destroy the genetic material of the cancer cells. Radiation will destroy the dangerous cells and stop them from reproducing. Care will be taken to ensure that radiation does not damage healthy cells within the eye. Besides radiation, your healthcare provider may choose to treat the melanoma with surgery. A number of surgical options are available that involve removal of parts of eye structures that are cancerous.

A Word From Verywell

It is estimated that about 3,000 new cases of eye melanoma are discovered each year in the United States. If detected early, treatment of eye melanoma can be very effective. According to the American Cancer Society, if the cancer affects only one eye, 80% of people will survive at least 5 years after diagnosis. If caught before they spread, most eye melanomas can be treated successfully.