Ocular melanoma

Other names

Malignant melanoma - choroid; Malignant melanoma - eye; Eye tumor.

Ocular melanoma (OM) is a cancer in pigment-producing cells of the eye called melanocytes. Melanocytes are cells that produce the pigment melanin that colors the skin, hair, and eyes, as well as forms moles.

Melanoma is a very aggressive type of cancer that can spread rapidly. It usually is a type of skin cancer. Melanoma of the eye can affect several parts of the eye, including:

• Choroid
• Ciliary body
• Conjunctiva
• Eyelid
• Iris
• Orbit

The choroid layer is the most likely site of melanoma in the eye. This is the layer of blood vessels and connective tissue between the white of the eye and retina (back of 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, melanoma that starts in the eye is rare.

Risk factors

Too much exposure to sunlight is an important risk factor for melanoma. People who have fair-skin and blue eyes are most affected.

Symptoms

Symptoms of melanoma of the eye may include any of the following:

• 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.

Diagnosis

An eye examination with an ophthalmoscope may reveal a single round or oval lump (tumor) in the eye. Tests that may be ordered include:

• Brain CT or MRI scan to look for spread (metastasis) to the brain
• Eye ultrasound
• Skin biopsy if there is an affected area on the skin

Treatment

Small melanomas may be treated with:

• Surgery
• Laser
• Radiation therapy (such as Gamma Knife, CyberKnife, brachytherapy)
• Surgery to remove the eye (enucleation) may be needed.

Other treatments that may be used include:

• Chemotherapy, if the cancer has spread beyond the eye
• Immunotherapy, which uses medicines to help your immune system fight the melanoma.

The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition.

• Aldesleukin (Brand name: Proleukin) Treatment of adults with metastatic melanoma.

Prognosis

The outcome for melanoma of the eye depends on the size of the cancer when it is diagnosed. Most people 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 long-term survival is much lower.

Prevention

The most important way to prevent melanoma of the eye is to protect the eyes from sunlight, especially between 10 a.m. and 2 p.m., when the sun's rays are most intense. Wear sunglasses that have ultraviolet protection.

A yearly eye exam is recommended.

NIH genetic and rare disease info

• NIH info on Ocular melanoma

Ocular melanoma is a rare disease.

Ocular melanoma Resources
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