Ocular/Uveal Melanoma: The Basics
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Melanoma is a type of cancer that starts in cells called melanocytes. Skin melanoma is more common than ocular (eye) melanoma. There are many types of ocular melanoma, and it often starts in the uveal tract, which is why it may be called ocular/uveal melanoma.
The uveal tract is the colored part under the white of the eye. The type of ocular melanoma you have is based on which part of the eye your cancer started in. Other types of melanoma that could be in the eye include choroidal, ciliary body, and conjunctival.
Risk Factors
Ultraviolet (UV) radiation from the sun or artificial sunlight from a tanning bed is the main cause of melanoma. Other risk factors are:
- Having fair skin.
- Having light colored eyes.
- Being an older age.
- If you were born female.
- Having dysplastic nevus syndrome (which means you have abnormal moles).
- If you or someone in your family has BAP1 cancer syndrome.
- Work exposure: If you work as a welder, you may be exposed to more UV light, which increases your risk.
Signs and Symptoms
Depending on where the melanoma is in your eye, you may or may not have symptoms. Symptoms can be:
- Vision changes: blurriness, vision loss, and/or seeing floaters (specks) or flashes of light.
- A dark spot on your iris (colored part of the eye).
- Change in pupil (dark circle in the eye) size or shape.
- Change in how the eyeball is positioned in the socket.
Screening
It is important to have a vision exam by a provider who specializes in looking at the eyes. These providers are called ophthalmologists or optometrists.
The American Optometric Association suggests that people ages 18 to 64 have an eye exam at least every 2 years, even if they are not at risk and do not have symptoms. For people ages 18 to 64 who are at risk or have symptoms, they should have an eye exam every year or as often as it is recommended by their healthcare provider. People ages 65 and older should have an eye exam every year or as often as it is recommended by their healthcare provider.
Diagnosis
If your healthcare provider thinks you have ocular melanoma, they will do tests like:
- Ultrasound.
- Optical coherence tomography (OCT): This allows images to be taken of the back of your eye.
- MRI.
- CT scan.
- Biopsy.
If a biopsy is done, you will get a pathology report. A pathology report describes all the aspects of the melanoma, which helps plan your treatment. You can ask for a copy of your report for your records. These tests can also check if the cancer has metastasized (spread) to other areas in your body.
Staging
The TNM system is used to stage ocular melanoma:
- T- Describes where the tumor is.
- N- Describes if the cancer has spread to the lymph nodes.
- M- Describes if the cancer has spread to other organs (metastases).
Staging ranges from I (one), limited disease, to IV (four), more advanced disease.
Treatment
The treatments for ocular melanoma are:
- Surgery: This is the most common treatment. The goal is to remove the tumor. Based on where the tumor is, some areas of the eye may also be removed.
- Radiation therapy: The use of high energy x-rays to kill cancer cells.
- Photocoagulation: The use of laser light to kill the blood vessels that are feeding the tumor.
Thermotherapy: The use of a heated laser to kill cancer cells.
This article is a basic guide to ocular/uveal melanoma. You can learn more about other types of melanoma by using the links below.