Eye melanoma (eye cancer)

Melanin, the pigment that gives skin its color, is also found in your eyes. That means they’re susceptible to the cancer that invades melanin-producing cells, called melanoma.

Eye melanoma, also called ocular melanoma, is cancer that starts in the tissues, skin, or area around the eye.

What causes eye melanoma?

We don’t yet know what causes eye cancer. But we do know that eye melanoma forms when the DNA in healthy eye cells malfunctions. The diseased cells mutate, grow, multiply and eventually come together to become an eye cancer.

Treating eye cancer

Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your overall health and your preferences.

Risk factors for developing ocular melanoma

According to the Mayo Clinic, risk factors for primary melanoma of the eye include:

  • Age. The risk of eye melanoma increases with age.
  • Being white. White people have a greater risk of eye melanoma than do people of other races.
  • Certain inherited skin disorders. A condition called dysplastic nevus syndrome, which causes abnormal moles, may increase your risk of developing melanoma on your skin and in your eye.
  • Light eye color. People with blue eyes or green eyes have a greater risk of melanoma of the eye.
Lady and man riding bikes

How can you tell if you have eye cancer?

Two hikers on a level path

Although eye cancer often has no early signs and symptoms, some that you can look out for include:

  • A change in the shape of the dark circle (pupil) at the center of your eye.
  • A growing dark spot on the iris.
  • A sensation of flashes or specks of dust in your vision (floaters).
  • Loss of peripheral vision.
  • Poor or blurry vision in one eye.

Diagnosing eye melanoma

A specialist may use different approaches to diagnose eye cancer, including:

  • Eye exam. Your doctor will start by looking for enlarged blood vessels on the outside of your eye, typical signs of tumors inside, and then use special instruments to look inside your eye.
  • Eye ultrasound. An eye ultrasound uses high-frequency sound waves from a hand-held, wand like apparatus called a transducer to produce images of your eye.
  • Imaging of the blood vessels in and around the tumor (angiogram). During an angiogram, a colored dye is injected into a vein in your arm where it quickly travels to the blood vessels in your eye. Once there, a camera with special filters detects the dye and takes flash pictures every few seconds for several minutes.

  • Optical coherence tomography. This test examines portions of the uvea and retina.
  • A tissue biopsy. Your doctor may remove a sample of tissue from your eye called a biopsy that they will examine it to determine whether it contains cancerous cells.

Treatments for eye cancer

Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your overall health and your preferences.

Note that if the melanoma is small and doesn’t appear to be growing, your doctor may choose to wait and watch for signs of growth before pursuing treatment.

Radiation therapy. Typically used for small to medium-sized eye cancers, radiation therapy uses targeted, high-powered energy like gamma rays to kill cancer cells.

Laser treatment. Sometimes used in combination with radiation therapy, lasers target and kill the melanoma cells.

Photodynamic therapy. Used in smaller tumors, photodynamic therapy combines medications with a special wavelength of light to kill eye cancer cells.

Surgery. Depending on the size and location of your eye cancer, surgery may be performed to remove either part of the eye or the entire eye.

If an eye is removed, an implant will replace it. Your surgeons will reconnect the muscles controlling movement of the eye to the implant so the implant can move.

After your eye has healed from surgery, an artificial eye (prosthesis) will be made and custom painted to match your existing eye.

Frequently asked questions (FAQs) about eye melanoma

Yes. Eye cancer has an incidence of 5 per million adults.

The prognosis for eye cancer is generally very good. According to the American Cancer Society, the 5-year relative survival rate for eye melanoma was 81%.

Many people with eye cancer find that their treatment effectively removes the cancer via surgery or destroys it via chemotherapy or radiation therapy. For some people, eye cancer may never go away, meaning they’ll have to continue their treatment for the rest of their lives.

Eye cancer can spread (metastasize) to the lungs, skin, and bone, but the liver is the most common organ in the body affected by eye cancer (occurring in 80% of cases). Eye cancer will spread in roughly 40-50% of individuals.

While we don’t yet know the cause of most eye cancers, we do know some practical steps you can take to prevent eye cancer, including applying sunscreen, limiting time in intense sunlight, and wearing protective hats, clothing, and sunglasses.