Ocular Melanoma

Ocular melanoma is a primary intraocular tumor: in 90% of cases, it is localized in the choroid, but it can also arise on the iris or on the optic nerve.

It is a rare cancer that develops from melanocytes, which are cells in the eye.

Primary cancers originate directly from the cells of the eye, while secondary cancers are metastases of other cancers that have reached the eye.

The most frequent primary ocular melanomas are those that originate in the uvea, that is, where the cells that produce melanin are present.

Risk Factors and Symptoms of Ocular Melanoma

It is not easy to identify risk factors: ethnicity, eye color, and some hereditary conditions have been identified as risk factors for melanoma. Excessive sun exposure and some professions where it is easy to come into contact with potentially harmful substances represent two other possible risk factors.

Among the hereditary factors we find:

  • dysplastic nevus syndrome
  • oculodermal melanocytosis

Ocular melanoma is usually asymptomatic; symptoms affecting vision appear when the disease is already in the advanced stage.

Symptoms include:

  • blurred vision
  • double vision
  • appearance of black spots
  • reduction of the visual field
  • flashes of light
  • pupil change


Diagnosis and Intervention

The diagnosis of ocular melanoma requires an ophthalmological specialist visit by an ophthalmologist oncologist; once melanoma is recognized, it is advisable to undergo further investigations such as radiography, tomography, and magnetic resonance imaging. For diagnostic purposes, other procedures are also used such as:

1- ophthalmological examination with pupil dilation

2- ocular ultrasound

3- angiography


How to Intervene?

The type of surgery on ocular melanoma depends on a number of factors such as, for example, the location of the tumor; it may also happen that the treatment may include more than one therapeutic option.

Surgery to date is a less common choice than radiotherapy which is used more often thanks to its ability to destroy cancer cells with extreme precision.

Patients with medium to small melanomas can be treated with conservative therapy that preserves the vision of the eye. In some cases, it is possible to perform precision surgery to remove the lesion before carrying out radiotherapy.

The removal of the eyeball is performed under general anesthesia: a biocompatible prosthesis anchored to the muscles is inserted into the orbit. The patient can be discharged after two days.