Malignant melanoma - eye

Alternative names
Malignant melanoma - choroid; Melanoma of the eye; Eye tumor; Ocular melanoma

Definition
Melanoma is a cancerous tumor that can occur in various structures in the eye, such as the choroid, the iris, or the ciliary body. The choroid layer is the most likely location of melanoma in the eye.

Causes, incidence, and risk factors

Melanoma is a very aggressive type of cancer that can spread rapidly. In the US, it occurs in about 6 people per million per year. Excessive exposure to sunlight is an important risk factor and the occurrence of melanoma has greatly increased in recent decades. Fair-skinned and blue-eyed people are affected most often.

The eye can be the primary site of the tumor, or the cancer may have spread to the eye from another location in the body. There may be no early symptoms, but the tumor will eventually cause a retinal detachment and distortion of vision.

Melanoma is the most common type of eye tumor in adults. Even so, primary melanoma of the eye is rare.

Symptoms

     
  • A red, painful eye  
  • Small defect on the iris or conjunctiva  
  • Iris color may change  
  • Poor vision in one eye  
  • Bulging eyes

In some cases, there may be no symptoms.

Signs and tests
An eye examination with an ophthalmoscope reveals a single round or oval lump (tumor) within the eye.

Tests may include:

     
  • Eye ultrasound examination  
  • Cranial CT scan to look for spread (metastasis) to the brain  
  • MRI of the head to look for metastasis to the brain  
  • Skin biopsy if there is an affected area on the skin

Treatment
Small melanomas may be treated by laser or by radiation therapy. Chemotherapy may be needed if the tumor has spread. Surgical removal of the eye may be necessary to prevent the spread of tumor to the brain or other organs.

Support Groups
For additional resources, see cancer support group.

Expectations (prognosis)

The outcome for melanoma of the eye depends upon the size of the cancer at the time of diagnosis. Between 60% and 80% of patients will survive at least 5 years from the time of diagnosis if the cancer has not spread outside the eye (metastasized).

If there has been spread outside the eye, the chance of survival is much lower.

Complications
Spread of the tumor to other areas of the body is a complication.

Calling your health care provider
Call for an appointment with your health care provider if a melanoma of the eye is suspected.

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.

Johns Hopkins patient information

Last revised: December 5, 2012
by David A. Scott, M.D.

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