Hi everyone. Today I want to talk about ocular melanoma, a type of melanoma that develops in the eye. While melanoma is usually associated with skin cancer, it can arise in the eye and spread to other parts of the body. Ultimatelym it can lead to death without there ever being a strange mole on the skin. Although dermatologists do not examine they eyes for ocular melanoma, we do recommend that any person with melanoma see an ophthalmologist for an eye exam to make sure that no other suspicious lesions are hiding in the eye.
Moles on the skin are comprised of cells called melanocytes. Melanocytes also are found in several parts of the eye. A person can have a mole in the eye and these moles can be atypical or even become melanoma. Often, these moles are asymptomatic and are found incidentally during an eye exam. At times, they cause pain or affect vision. Most commonly, ocular melanoma develops in the uvea of they eye but can also form on the conjunctiva.
Fortunately, these melanomas are relatively rare, affecting about six people per million in the United States. However, they tend to be discovered at a later stage so their spread to other parts of the body is common. More incidents of ocular melanoma are found in the southern part of the country, perhaps because people there have an increased amount of sun exposure. People with relatives who have had ocular melanoma may be at higher risk, although no definite genetic link is known.
Individuals with "dysplastic nevus syndrome" are also at higher risk. This syndrome is characterized by many (dozens to hundreds) atypical appearing moles on the skin and is associated with an increased risk of cutaneous and ocular melanoma. These people tend to be monitored closely by their dermatologists and have many moles biopsied during their lifetime.
Treatment for ocular melanoma involves surgical excision in most cases, although some cases are treated with radiation. Treatment is usually determined on a case by case basis in collaboration with an ophthalmologist and an oncologist. Because this type of tumor can potentially spread to other parts of the body, tests are usually done to look for any signs of the melanoma elsewhere (blood work along with imaging scans). The liver is the most common organ to which this type of melanoma spreads, though it can spread to other organs as well.
So what does this mean for the average person with no family history of ocular melanoma and no reason to believe there is a melanoma lurking in their eye? Protect your eyes from the sun by using sunglasses and hats -sunlight may contribute to the development of melanoma in the eye, as well as other problems. An eye exam by an ophthalmologist should be done regularly (the frequency can be determined by your ophthalmologist). Any nevus of the eye should be monitored for growth and changes. Of course, any pain in the eye or changes in vision should be evaluated as soon as possible by your doctor.
Published On: September 25, 2007