Ocular Melanoma: Symptoms and Causes

Ocular melanoma is a chronic disease that affects the eye. While it may go unnoticed in its early stages, over time it can lead to vision problems and blindness. Find out more.
Ocular Melanoma: Symptoms and Causes

Last update: 05 October, 2021

Ocular melanoma is a health issue that can affect our eyes. Melanoma is a type of cancer that originates from cells, melanocytes, which are responsible for producing the pigment that gives color to the skin, eyes, and hair.

Now, how does this type of cancer develop, how can doctors detect it, and what are its most characteristic symptoms? We’ll tell you all this, as well as other interesting facts, in this article!

What is ocular melanoma?

Ocular melanoma, as its name suggests, is a type of melanoma that affects the eye.

The eye has many parts, so this form of melanoma and its name will depend on the area of the eye that’s affected.

When ocular melanoma affects the uvea, the layer of the eye responsible for transporting blood within this organ, it’s uveal melanoma. The latter makes up 85% of the cases of ocular melanoma in the world, affecting about 6 people per million inhabitants per year.

Causes of ocular melanoma

Today, the mechanisms that result in ocular melanoma aren’t completely clear. However, there are risk factors that specialists associate with the development of this disease. We can highlight the following:

  • Skin color (98% of cases occur in fair-skinned people)
  • The light color of the iris (linked to gene mutations predisposing to some type of melanoma)
  • Presence of atypical moles on the skin

Specialists also believe that advanced age (over 70 years of age) plays an important role in the appearance of this disease. On the other hand, some diseases seem to have a relation to this health issue:

  • Oculodermal melanocytosis
  • Neurofibromatosis type 1
  • Li-Fraumeni syndrome
  • Melanoma in any other part of the body (risk of metastasis to the eyeball)
A man getting an eye exam
In many cases, ocular melanoma occurs without symptoms. For this reason, doctors often detect it through examinations due to suspicion of an ocular problem.

Symptoms and diagnosis

Establishing a standard for the symptoms presented in this health issue is difficult. The presentation of symptoms varies depending on the location of the ocular lesion. In fact, it’s most common for affected individuals to have no symptoms at all. This means we have to be really alert to our visual health.

When symptoms occur, they’re usually related to the fact that it affects the retina and causes loss of vision, light or flashing vision, and visual field defects.

Ocular melanoma doesn’t cause any pain unless it spreads to the structures surrounding the eye. This increases the pressure inside the eye or causes inflammation.

Since the symptoms are quite inaccurate, the diagnosis of ocular melanoma is usually incidental. This means that specialists often discover it during routine eye examinations or by visits to the ophthalmologist under suspicion of an eye condition.

When specialists suspect ocular melanoma, the diagnosis is usually aided by ocular ultrasound, which confirms the disease in 95% of cases.

Treatment

In the past, doctors treated ocular melanoma by enucleating the eye (removal) of the affected person. Today, this practice is no longer used thanks to advances in oncologic treatments.

Radiation therapy and targeted chemotherapy help the eyeball to be preserved in 90% of cases. However, high radiation can cause damage or loss of vision due to retinal and optic nerve involvement.

Photodynamic therapy holds the promise of solving these problems, but it isn’t universally accepted yet due to a lack of supporting data.

A doctor diagnosing an eye problem

Other organ involvement and survival

One of the biggest concerns for people affected by ocular melanoma after cure is the likelihood of the cancer appearing elsewhere in the body.

According to a study presented in 2009, 25-33% of patients who had this health issue were diagnosed with metastatic cancer within 10 years. The liver is the organ most affected by metastasis in these cases.

While some experts advocate routine studies every 4 to 6 months for the early detection of metastases, others believe that this measure has no impact. Some studies suggest that early detection of metastatic cancer isn’t associated with improved patient survival.

In summary, patients with ocular melanoma have a relatively good survival rate of 70-80% 5 years after diagnosis.

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