Eye Melanoma Explained

What is Melanoma in and around the eye?

Also known as ocular melanoma, melanoma in or around the eye is a type of cancer that develops in the cells that produce pigment. It is the most common eye cancer in adults but very rare in general. It begins in the middle of the three layers of your eye. The outer layer of your eye is the sclera, the innermost layer is the retina and the middle layer between the sclera and retina is called the uvea. Eye melanoma also rarely occurs on the conjunctiva. Most eye melanomas are difficult to detect as they form in the part of the eye you can’t see when looking in a mirror.

What causes ocular melanoma?

It is still unclear why eye melanomas develop. It sometimes occurs when the DNA of the eye pigment cells develop errors. These then cause the cells to multiply and the mutated cells collect in or on the eye and form a melanoma.

Risk factors include:

• Exposure to natural sunlight or artificial sunlight and high propensity to sunburn
• Having light-colored eyes, fair skin color
• Old age
• Certain inherited skin conditions, such as dysplastic nevus syndrome
• Having abnormal skin pigmentation involving the eyelids
• Having a mole in the eye or on the eye’s surface

Symptoms

Ocular melanoma in its early stages does not show any symptoms. This is due to melanomas developing in the part of the eye you cannot see such as:

• A dark spot on the iris or conjunctiva
• Blurred or distorted vision or a blind spot in your side vision
• The sensation of flashing lights or sparks of dust in your vision
• A change in the shape of the pupil

If you are diagnosed with ocular melanoma, your treatment will vary and will depend on:

• The location and size of the melanoma
• And your general health

Generally, treatment includes radiation and surgery.

In radiation therapy, various types of radiation are used to kill melanoma or keep it from growing. For smaller tumours, laser, heat energy, or both may be used for treatment.

Depending on the size and location of the melanoma, surgery may be recommended. The surgery may involve removing the tumour and some of the healthy tissue of the eye surrounding it.

For larger tumours, tumours that cause eye pain, and tumours involving the optic nerve, the surgery may involve removing the entire eye. Both radiation and surgery can, however, damage the vision in your eye.

Dr Ntomboxolo Mboyi has a BSc (UKZN), MBCHB (Medunsa), Fc Rad Onc (SA), and is a Postgraduate in Cancer Biology and Therapeutics: High Impact Cancer Research Program (Harvard Medical School). She is a member of the South African Oncology Consortium (SAOC), South African Society of Clinical and Radiation Oncology (SASCRO), American Society of Clinical Oncology (ASCO), and American Brachytherapy Society (ABS) and a Chairperson of the leading body of CanSurvive, a non-benefit association offering support to cancer patients.