Eye Melanoma - Causes, Symptoms, Diagnosis, Prevention & Treatment

Eye Melanoma

Dr.I P Singh profile Authored by Dr.I P Singh on 6 Feb 2015 - 09:35.

Melanoma is known as the cancer of the melanin (a pigment responsible for skin colour) producing cells that often spreads rapidly. Ocular/ sclera or eye melanoma is a cancer of the eye affecting multiple parts of the eye, including iris, orbit, ciliary body, conjunctiva (conjunctival melanoma), eyelid, choroid, etc. However, melanoma of choroid, ciliary body and iris (uveal melanoma) are most common.

Eye melanoma develops when a sudden mutation in melanin producing cells causes uncontrolled growth of pigment cells in the eye. Eye melanoma can affect anybody at any age, but according to “American Cancer Society”, it’s more common in people over 50 years.

Depending upon its origin, eye melanoma can be categorized as:

  • Primary tumor which begins in the eye itself.
  • Secondary tumor occurs as a result of metastasis (cancer spreads from one body part to another).

 

 

 

The exact cause of eye melanoma is not clear yet, but it is believed to be linked to sudden mutations in the DNA regulating eye and its function. Mutations in the DNA may occur due to various reasons; one of them may include prolonged exposure to ultraviolet (UV) radiation.

Most of eye melanomas occur in the hidden parts of the eyes that cannot be seen easily and may remain undiagnosed until it presents symptoms. Common signs and symptoms of eye melanoma may include:

  • Appearance of dark spot in the eye
  • Increased sensitivity to light
  • Altered shape of the pupil (dark circle at the center of the eye)
  • Blurred vision, typically in (affected) one eye
  • Altered peripheral vision (a part of vision that occurs outside the retina and involves rods and nerves).
  • Discoloration of the iris
  • Bulging of the eyes
  • Reddening and swelling of the eye/s
  • Pain in the eyes
  • Defect in the conjunctiva or iris

When to see a doctor?

Seek immediate medical care if you notice sudden changes in your vision, eye, dark spots or some other symptoms worrying you.

 

 

 

As melanoma occurs in the hidden parts in the eye/s, it does not show any early symptoms, making diagnosis difficult. Diagnosis may include the following tests and procedures:

  • General eye examination for symptoms and signs of tumor in the eye.
  • Ophthalmoscopy and slit-lamp bio-microscopy to check the interior of the eye for abnormal signs.
  • Ultrasound of the eye to see images of the eye using transducer.
  • Angiogram (using dye), for identifying the tumor blood vessels.
  • Color fundus photography is done to compare the affected area before and after the treatment. Fundus is the back portion of the eye.
  • Biopsy (tissue removed from the affected eye) is done to obtain signs of a tumor.

Following diagnostic tests are done to check its spread to other parts of the body:

  • Blood tests/ liver function test
  • Chest X- ray

Other imaging modalities: CT scan, MRI, PET scans and ultrasound of the abdomen may be considered to check for metastasis by obtaining a clear picture of the body.

 

 

 

Following factors may increase the risk of getting primary eye melanoma:

  • Having fair skin
  • Having light colored eyes (blue or green)
  • Being older (above 50 years)
  • Underlying genetic diseases of the skin
  • Prolonged exposure to sun

Complications:

When kept untreated or if poorly treated, eye melanoma may lead to the following severe consequences:

  • Glaucoma (a condition causing excessive pressure in the eye)
  • Retinal detachment causing loss of vision
  • Difficulty in seeing on the side or center
  • Rarely complete vision loss may also occur
  • Eye melanoma may spread to liver, bones &connective tissues and lungs.

 

 

 

Most eye melanomas, especially small spots may not interfere with the vision and hence may not require any treatment. A variety of treatment approaches may be chosen to treat large melanomas with an aim to destroy cancer cells, prevent recurrence and restore vision.

Some common approaches may include:

  • Radiation therapy: to destroy the cancer cells of medium sized tumors.
  • Brachytherapy to destroy cancer cells by placing radioactive material on the eye using temporary stitches.
  • Tele therapy is a procedure of radiation using a special machine (for several days) to kill the cancer cells.
  • Laser treatment: Laser beams are used to destroy the cancer cells.
  • Transpupillary thermotherapy (TTT) /Thermo therapy uses infrared laser with or without radiation therapy.
  • Cryotherapy is a rarely used approach that utilizes extreme cold to destroy the cancer cells (small melanoma).

Surgical interventions: Depending upon the size and location of the melanoma the following procedures may be used:

  • Surgery to remove small melanoma
  • Iridectomy is used to remove melanoma in the iris and a band of some surrounding tissues.
  • Choroidectomy is used to remove the melanoma in the choroid
  • Enucleation is a procedure of removing the entire eye. It is especially indicated in large and painful eye melanomas. Later, an implant may be placed in the vacant space and the muscles may be attached to restore the movement.

Diet and nutrition recommendations:

  • Broccoli
  • Flax seeds (omega 3 fatty acids)
  • Blueberries
  • Apples, etc.
  • Foods rich in vitamin D3 or supplements
  • Melatonin supplements
  • Foods rich in selenium or supplements
  • Other supplements including CoQ10, Lycopene, Alpha Lipoic Acid and so on. 

 

 

 

As such, none of the approaches can assure complete prevention of eye melanoma but combating risk factors may help to protect you. Following are the recommendations:

  • Avoid long term exposure to sunlight
  • Use uniformly dark lenses
  • Use sunglasses
  • Prefer wraparound frames that protect from side too
  • Quitting smoking, alcohol, tobacco, etc.
  • Maintain good health.

 

 

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.