Key Points for This Section

Intraocular melanoma is a disease in which malignant (cancer) cells form in the tissues of the eye. Age and sun exposure may increase the risk of developing intraocular melanoma. Possible signs of intraocular melanoma include a dark spot on the iris or blurred vision. Tests that examine the eye are used to help detect (find) and diagnose intraocular melanoma. Certain factors affect prognosis (chance of recovery) and treatment options.

Intraocular melanoma is a disease in which malignant (cancer) cells form in the tissues of the eye.

Intraocular melanoma begins in the middle of 3 layers of the wall of the eye. The outer layer includes the white sclera (the "white of the eye") and the clear cornea at the front of the eye. The inner layer has a lining of nerve tissue, called the retina, which senses light and sends images along the optic nerve to the brain.

The middle layer, where intraocular melanoma forms, is called the uvea or uveal tract, and has 3 main parts:

Iris

The iris is the colored area at the front of the eye (the "eye color"). It can be seen through the clear cornea. The pupil is in the center of the iris and it changes size to let more or less light into the eye.

Ciliary body

The ciliary body is a ring of tissue with muscle fibers that change the size of the pupil and the shape of the lens. It is found behind the iris. Changes in the shape of the lens help the eye focus. The ciliary body also makes the clear fluid that fills the space between the cornea and the iris.

Choroid

The choroid is the layer of blood vessels that bring oxygen and nutrients to the eye. Most intraocular melanomas begin in the choroid.

Enlarge

Anatomy of the eye, showing the outside and inside of the eye including the sclera, cornea, iris, ciliary body, choroid, retina, vitreous humor, and optic nerve. The vitreous humor is a liquid that fills the center of the eye.

Intraocular melanoma is a rare cancer, but it is the most common eye cancer in adults.

Age and sun exposure may increase the risk of developing intraocular melanoma.

Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. People who think they may be at risk should discuss this with their doctor. Risk factors for intraocular melanoma include the following:

• Older age.
• Being white.
• Having a fair complexion (light skin) or green or blue eyes.
• Being able to tan.

Possible signs of intraocular melanoma include a dark spot on the iris or blurred vision.

Intraocular melanoma may not cause any early symptoms. It is sometimes found during a routine eye exam when the doctor dilates the pupil and looks into the eye. The following symptoms may be caused by intraocular melanoma or by other conditions. A doctor should be consulted if any of these problems occur:

• A dark spot on the iris.
• Blurred vision.
• A change in the shape of the pupil.
• A change in vision.

Glaucoma may develop if the tumor causes the retina to separate from the eye. If this happens, there may be no symptoms, or symptoms may include the following:

• Eye pain.
• Blurred vision.
• Eye redness.
• Nausea.

Tests that examine the eye are used to help detect (find) and diagnose intraocular melanoma.

The following tests and procedures may be used:

• Eye exam with dilated pupil: An examination of the eye in which the pupil is dilated (enlarged) with medicated eyedrops to allow the doctor to look through the lens and pupil to the retina. The inside of the eye, including the retina and the optic nerve, is examined using an instrument that produces a narrow beam of light. This is sometimes called a slit-lamp exam. The doctor may take pictures over time to keep track of changes in the size of the tumor and how fast it is growing.
• Indirect ophthalmoscopy: An examination of the inside of the back of the eye using a small magnifying lens and a light.
• Ultrasound exam of the eye: A procedure in which high-energy sound waves (ultrasound) are bounced off the internal tissues of the eye to make echoes. Eye drops are used to numb the eye and a small probe that sends and receives sound waves is placed gently on the surface of the eye. The echoes make a picture of the inside of the eye. The picture, called a sonogram, shows on the screen of the ultrasound monitor.
• Transillumination of the globe and iris: An examination of the iris, cornea, lens, and ciliary body with a light placed on either the upper or lower lid.
• Fluorescein angiography: A procedure to look at blood vessels and the flow of blood inside the eye. An orange fluorescent dye (fluorescein) is injected into a blood vessel in the arm. As the dye travels through blood vessels of the eye, a special camera takes pictures of the retina and choroid to detect any blockage or leakage.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

• The type of melanoma cells (how they look under a microscope).
• The size of the tumor.
• Which part of the eye the tumor is in (the iris, ciliary body, or choroid).
• Whether the tumor has spread within the eye or to other places in the body.
• The patient's age and general health.
• Whether the tumor has recurred (come back) after treatment.

In patients with small tumors that have not spread, intraocular melanoma can be cured and vision can usually be saved.

Glossary Terms

A procedure to x-ray blood vessels. The blood vessels can be seen because of an injection of a dye that shows up in the x-ray.

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

A tube through which the blood circulates in the body. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

A dye or other substance that helps show abnormal areas inside the body. It is given by injection into a vein, by enema, or by mouth. Contrast material may be used with x-rays, CT scans, MRI, or other imaging tests.

The transparent part of the eye that covers the iris and the pupil and allows light to enter the inside.

To heal or restore health; a treatment to restore health.

To widen or enlarge an opening or hollow structure beyond its usual size, such as the pupil of the eye or a blood vessel.

Cancer that forms in tissues of and around the eye. Some of the cancers that may affect the eye include melanoma (a rare cancer that begins in cells that make the pigment melanin in the eye), carcinoma (cancer that begins in tissues that cover structures in the eye), lymphoma (cancer that begins in immune system cells), and retinoblastoma (cancer that begins in the retina and usually occurs in children younger than 5 years).

Liquid.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

A rare cancer of melanocytes (cells that produce the pigment melanin) found in the eye. Also called ocular melanoma.

In medicine, to regularly watch and check a person or condition to see if there is any change. Also refers to a device that records and/or displays patient data, such as for an electrocardiogram (EKG).

A feeling of sickness or discomfort in the stomach that may come with an urge to vomit. Nausea is a side effect of some types of cancer therapy.

A bundle of fibers that receives and sends messages between the body and the brain. The messages are sent by chemical and electrical changes in the cells that make up the nerves.

A chemical compound (such as protein, fat, carbohydrate, vitamin, or mineral) contained in foods. These compounds are used by the body to function and grow.

The nerve that carries messages from the retina to the brain.

The likely outcome or course of a disease; the chance of recovery or recurrence.

To come back or to return.

The light-sensitive layers of nerve tissue at the back of the eye that receive images and sends them as electric signals through the optic nerve to the brain.

Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

A computer picture of areas inside the body created by bouncing high-energy sound waves (ultrasound) off internal tissues or organs. Also called an ultrasonogram.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A group or layer of cells that work together to perform a specific function.

An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancerous), or malignant (cancerous). Also called neoplasm.

A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echo patterns are shown on the screen of an ultrasound machine, forming a picture of body tissues called a sonogram. Also called ultrasonography.