Intraocular Melanoma

Intraocular melanoma is the most common eye cancer in adults.  The most common location for intraocular melanoma is the choroid, followed by the ciliary body and iris.

This cancer often does not cause any symptoms in its early stages, so the tumor may grow for some time before the problem becomes noticeable.  Diagnosis occurs sometimes on routine exams of the retina or if the patient experiences symptoms. When symptoms occur, they include blurred vision, floaters, flashing lights, or sever eye pain.  These symptoms also can be caused by many other, more common, noncancerous causes.

Ocular Melanoma

In the United States, choroidal melanoma affects approximately 2500 people per year with an incidence of 6 per million. Ocular melanoma is more common in fair-skinned individuals. Smoking increases the risk for the condition, which typically affects people in their 60s. Unlike skin (cutaneous) melanoma, ocular melanoma is generally not associated with previous sun exposure.

During a targeted tumor examination, diagnostic testing typically includes a complete eye exam with dilation of the fundus, indirect ophthalmoscopy, fundus photography, ultrasound, fluorescein angiography, and OCT.  These imaging studies evaluate the tumor, allowing documentation of the clinical diagnosis.  The ocular tumor is then staged—a process that defines the extent of tumor based on its length, width, and height.

Further testing is indicated to determine whether the eye tumor is present outside of the eye (metastatic screening).

Treatment is then planned depending on size of the tumor.  Local radiation therapy is most commonly done with the placement of a radioactive plaque in the location of the tumor which is then removed typically 1 week later.  If the tumor is very large, the eye may have to be removed (enucleation).