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Melanoma of the eye
Definition
Melanoma of the eye is cancer that occurs in various parts of the eye.
Alternative Names
Malignant melanoma - choroid; Malignant melanoma - eye; Eye tumor; Ocular melanoma
Causes
Melanoma is a very aggressive type of cancer that can spread rapidly.
Melanoma of the eye can affect several parts of the eye, including the:
- Choroid
- Ciliary body
- Conjunctiva
- Eyelid
- Iris
- Orbit
The choroid layer is the most likely location of melanoma in the eye.
The cancer may only be in the eye, or it may spread (metastasize) to another location in the body, most commonly the liver. Melanoma can also begin on the skin or other organs in the body and spread to the eye.
Melanoma is the most common type of eye tumor in adults. Even so, primary melanoma of the eye is rare.
Excessive exposure to sunlight is an important risk factor. The occurrence of melanoma has greatly increased in recent decades. Fair-skinned and blue-eyed people are most often affected.
Symptoms
- Bulging eyes
- Change in iris color
- Poor vision in one eye
- Red, painful eye
- Small defect on the iris or conjunctiva
In some cases, there may be no symptoms.
Exams and Tests
An eye examination with an ophthalmoscope may reveal a single round or oval lump (tumor) in the eye.
Tests may include:
- Cranial CT scan to look for spread (metastasis) to the brain
- Eye ultrasound
- MRI of the head to look for spread (metastasis) to the brain
- Skin biopsy if there is an affected area on the skin
Treatment
Small melanomas may be treated with:
- Brachytherapy
- Lasers
- Radiation therapy
Surgical removal of the eye (enucleation) may be needed.
Chemotherapy or biological therapy (interferon) are considered less effective treatments for melanoma of the eye.
Support Groups
For additional resources, see cancer support group.
Outlook (Prognosis)
The outcome for melanoma of the eye depends on the size of the cancer at the time of diagnosis. Most patients will survive at least 5 years from the time of diagnosis if the cancer has not spread outside the eye.
If the cancer has spread outside the eye, the chance of survival is much lower.
Possible Complications
- Distortion or loss of vision
- Retinal detachment
- Spread of the tumor to other areas of the body
When to Contact a Medical Professional
Call for an appointment with your health care provider if you have symptoms of melanoma of the eye.
Prevention
The most important way to prevent eye melanoma is to avoid excessive exposure to sunlight, especially between 10 a.m. and 2 p.m., when the sun's rays are most intense. Wear sunglasses, and be sure they have ultraviolet protection.
A yearly eye exam is recommended.
References
Karcioglu ZA, Haik BG. Eye, orbit, and adnexal structures. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 71.
Folberg R. The eye. In: Kumar V, Abbas AK, Fausto N, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 29.
Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
