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Melanoma of the eye

Definition:

Melanoma of the eye is cancer that occurs in various parts of the eye.



Alternative Names:

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



Causes, incidence, and risk factors:

Melanoma is a very aggressive type of cancer that can spread rapidly.

Melanoma of the eye can affect several parts of the eye, including the:

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

The choroid layer is the most likely location of melanoma in 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, primary melanoma of the eye is rare.

Excessive exposure to sunlight is an important risk factor. The occurrence of melanoma has greatly increased in recent decades. Fair-skinned and blue-eyed people are most often affected.



Symptoms:

In some cases, there may be no symptoms.



Signs and tests:

An eye examination with an ophthalmoscope may reveal a single round or oval lump (tumor) in the eye.

Tests may include:



Treatment:

Small melanomas may be treated with:

Surgical removal of the eye (enucleation) may be needed.

Chemotherapy or biological therapy (interferon) are considered less effective treatments for melanoma of the eye.



Support Groups:

For additional resources, see cancer support group .



Expectations (prognosis):

The outcome for melanoma of the eye depends on the size of the cancer at the time of diagnosis. Most patients will 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 survival is much lower.



Complications:
  • Distortion or loss of vision
  • Retinal detachment
  • Spread of the tumor to other areas of the body


Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of melanoma of the eye.



Prevention:

The most important way to prevent eye melanoma is to avoid excessive exposure to sunlight, especially between 10 a.m. and 2 p.m., when the sun's rays are most intense. Wear sunglasses, and be sure they have ultraviolet protection.

A yearly eye exam is recommended.



References:

Karcioglu ZA, Haik BG. Eye, orbit, and adnexal structures. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG, eds. Clinical Oncology. 4th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 71.

Folberg R. The eye. In: Kumar V, Abbas AK, Fausto N, Aster JC, eds. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 29.

Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 431.




Review Date: 9/9/2012
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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