Eye Cancer: Melanoma in the Eye

What is melanoma in the eye?

Melanoma is a type of cancerous tumor in the eye. It is also called intraocular melanoma. The part of the eye affected by this rare type of cancer is the uvea. The uvea is made up of:

• the iris (the colored part of the front of the eye that surrounds the pupil)
• the ciliary body (a muscle that helps the eye focus and makes the fluid that fills the front of the eye)
• the choroid (a layer of tissue in the back of the eye, behind the retina)

The location of the melanoma in the uvea affects its symptoms and treatment.

What is the cause?

Melanoma in the eye happens when cells that produce pigment grow uncontrollably. Pigment produces the coloring of the skin and iris of the eye. What causes the abnormal growth of cells is not known. People with light-colored skin and eyes may have a higher chance of developing melanoma than people with darker skin. Rarely, this type of cancer starts in another part of the body and spreads to the eye.

What are the symptoms?

Often melanomas cause no symptoms. Sometimes they may cause painful, red eyes or changes in your vision.

A melanoma of the iris may look like a dark spot on the iris. It may block part of your vision. A melanoma on the ciliary body or the choroid may cause blurred vision in one eye or loss of side vision.

How is it diagnosed?

The tumor is usually found during a routine eye exam before you start having symptoms. If your provider sees a tumor, you may have an ultrasound scan to see what kind of tumor it is.

How is it treated?

If the tumor is small, causes no problems, and is not growing, your eye care provider may not recommend any treatment. He or she will check the tumor regularly to see if it is changing.

Melanoma in the eye is a serious and sometimes fatal disease because it can spread to other parts of your body. The main goal of treatment is to limit the growth and spread of the disease. Often melanomas in the eye are treated by providers who are specialists in the treatment of tumors inside the eye.

Common types of treatment are:

• Surgery to remove the tumor and affected parts of the eye. Sometimes the whole eye must be removed.
• Internal radiation therapy. Small implants of material containing radiation (radioisotopes) are placed on the outside wall of the eye, over the tumor. The implants, called plaques, deliver radiation to kill cancer cells and shrink the tumor.
• External beam irradiation therapy. In this procedure, a machine delivers precise beams of X-rays or other high-energy rays to kill cancer cells and shrink tumors.
• Laser therapy, which uses a very powerful beam of light to destroy the tumor or blood vessels that feed the tumor.

Blood tests and imaging studies such as X-rays, CT scans, PET scans, or an MRI may be done to see if the cancer has spread. These tests may need to be repeated regularly.

How long will the effects last?

Recovery depends on the size and cell type of the cancer, where the cancer is in the eye, and whether the cancer has spread. If the cancer has not spread to other parts of the body, the long-term survival rates are good. Although saving your vision is a goal, it is often not possible to treat the tumor without some vision loss.

After treatment your eye care provider will recommend regular checkups to follow your recovery and to see if the cancer has come back or spread. It is important to keep appointments for checkups so that any problems can be found early.

How can it be prevented?

There is no known way to prevent melanomas in the eye.