Melanoma of the eye

Also known as: Malignant melanoma - choroid, Malignant melanoma - eye, Eye tumor or Ocular melanoma

Definition

Melanoma of the eye is cancer that occurs in various parts of the eye.

Causes, incidence, and risk factors

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.

Signs 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 metastasis to the brain
• Skin biopsy if there is an affected area on the skin

Treatment

Small melanomas may be treated with lasers, brachytherapy, or radiation therapy.

Surgical removal of the eye (enucleation) may be necessary.

Chemotherapy or biological therapy (interferon) are considered less effective therapies for melanoma involving the eye.

Support Groups

For additional resources, see cancer support group.

Expectations (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.

Complications

• Distortion or loss of vision
• Retinal detachment
• Spread of the tumor to other areas of the body

Calling your health care provider

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

In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 73.

See also:

• Special Topic

  Choroid

  

  The choroid is the layer of blood vessels and connective tissue between the (white of the eye) and . It is part of the and supplies nutrients to the inner parts of the eye. Inflammation of the choroid is called .

• Disease

  Melanoma

  

  Melanoma is the most dangerous type of skin cancer. It is the leading cause of death from skin disease. It involves cells called melanocytes, which produce a skin pigment called melanin. Melanin is responsible for skin and hair color. Melanoma can also involve the colored part of the eye. For ...

• Disease

  Tumor

  A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or noncancerous (benign).

• Disease

  Retinal detachment

  

  Retinal detachment is a separation of the light-sensitive membrane in the back of the eye (the retina) from its supporting layers.

• Special Topic

  Proton therapy

  Proton therapy is a kind of used to treat cancer. Like other types of radiation, proton therapy kills cancer cells and stops them from growing.

Review date:

August 18, 2009

Reviewed by:

Daniel E. Bustos, MD, MS, Private Practice specializing in Comprehensive Ophthalmology in Eugene, OR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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