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Melanoma is a serious kind of skin cancer. This cancer involves cells called melanocytes. You also have melanocytes in your eyes. When these cells become cancerous, the condition is called intraocular melanoma. It's not as common as skin melanoma, but it, too, can be life-threatening.
Ocular melanoma is the most common type of cancer of the eye, but it is still rare. Ocular melanoma is more common in people with light skin, and it most often strikes people in their mid-50s. But, people of any age and race can develop the disease.
In most cases, the disease begins in a layer of the eye called the choroid. This layer of blood vessels brings oxygen and nutrients to the eye. The cancer can travel to other parts of your body, to both nearby tissues and more distant places through your lymph system or bloodstream. It can also involve the iris, ciliary body, conjunctiva, or eyelid.
A small growth may not cause any symptoms. As it grows larger your symptoms may include:
Blurry vision or sudden loss of vision
Soreness in an eye, bulging of the eye
Flashes or "floaters" in your vision
Dark spot on your iris, the colored ring at the front of your eye
Change in the shape of your pupil, the black circle at the front of your eye
If you have this condition, your eye doctor may see it during a routine eye exam.
Your eye doctor may be able to diagnose intraocular melanoma just by examining your eye. The doctor does this by looking into your eye through the pupil using a direct ophthalmoscope, which consists of a light and small magnifying glass, or an indirect ophthalmoscope, which is similar to a microscope. Doctors sometimes use these other methods to make a diagnosis:
CT scans. CT scans of your eye use X-rays to painlessly create detailed cross-sectional images of your eye.
Ultrasound. This uses high frequency sound waves to view inside the eye.
MRI scan. MRIs use radio waves and strong magnets to create an image. This test is helpful in determining the size of the tumor and if the cancer has spread.
Angiography. During this procedure, the doctor injects dye into a blood vessel in your arm. Then the doctor takes pictures of your eye, and the dye helps to show the findings more clearly.
Biopsy. The doctor may need to take a small sample of tissue from the growth. This is not often used due to the risk of eye damage.
Depending on your situation, you may have several options for treating this disease:
Surgery. This is a common approach. The doctor may need to only remove the growth and a small area of tissue around it. In some cases, however, the doctor will need to remove the entire eye and possibly other surrounding tissues, such as the eyelid and muscles around the eye.
Radiation. Different types of radiation are sometimes used for treating this disease. The doctor may use a machine to direct beams of radiation into your eye. Another approach is to attach a small disk containing radioactive seeds on your eye next to the tumor. If you have this procedure, you'll have anesthesia to put you to sleep before it begins. The disk usually stays in place for about a week.
Photocoagulation. Your doctor may use a special laser that destroys blood vessels that feed the tumor. This is more often used for small tumors.
Thermotherapy. This is the use of heat, which destroys the cancer cells.
Certain factors may make you more likely to develop intraocular melanoma. Some factors you can't change, such as being older or having light skin that burns easily. Other factors you can control. For instance, repeatedly being exposed to sunlight or tanning beds over time may raise your risk. But experts don't know this for sure.
Your doctor may recommend that you not begin treatment right away. This is called "watchful waiting." The doctor will check on you regularly and take pictures of the tumor to track its growth.
You may need additional treatments for the cancer if it spreads to other parts of your body.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.