Ocular melanoma is a very rare type of cancer. Each year, only 2,500 people — or about 5 in 1 million — receive
a diagnosis with this type of eye cancer.
According to the American Academy of Ophthalmology, ocular melanoma is rare but is the most common primary
cancer of the eye in adults. The cancer develops in the cells that produce the eye’s pigment. It can also develop on
the conjunctiva, the mucus membrane that cover the eye and line the eyelid. It develops from the cells that produce
the dark-colored pigment melanin which is responsible for our skin’s coloring. These cells, called melanocytes, are
found in other places in our bodies too: our hair, the lining of our internal organs, and our eyes. So while most
melanomas do form on the skin, it is possible for a melanoma to form elsewhere. When it forms in the eye, it’s
known as ocular melanoma or, more specifically, uveal melanoma.
Most eye melanomas develop in a part of the eye you can’t see but your eye doctor can once you’re dilated. This is
one of several reasons why your eye doctor wants to dilate your pupils when you come in for your eye
examinations. The early stages of the cancer rarely cause any signs or symptoms. That’s why you might not be able
to spot this type of melanoma the way you might a freckle or unusual mole on your skin.
People may spot warning signs of the cancer as it grows. Symptoms of ocular melanoma include blurry or distorted
vision, a blind spot in your vision, seeing “flashing” lights, or a dark spot in your field of vision similar to that of a
retinal detachment.
As the cancer progresses, you may notice that the shape of your pupil changes. A dark spot or “freckle” may
develop on the iris, the colored part of the eye.
If your eye doctor sees a melanoma in your eye, they will refer you to a retinal specialist, and then ultimately to an
ocular oncologist who makes the diagnosis and decides treatment options.
Ocular Melanoma Foundation statistics identify 55 years of age as the median age for an ocular melanoma
diagnosis. Approximately 50% of patients with ocular melanoma will develop metastases by 10 to 15 years after
diagnosis (a small percentage of people will develop metastases even later i.e. 20-25 years after their initial
diagnosis).
Metastatic disease has been universally fatal but new treatments show great promise.
- Immunotherapy treatment helps the body’s immune system attack melanoma cells more effectively.
Some forms of immune therapy are already used to treat some melanomas. - Melanoma vaccines are being studied in clinical trials.
- Some early studies have shown that treating patients with high doses of chemotherapy and radiation therapy
and then giving them tumor-infiltrating lymphocytes (TILs), which are immune system cells taken from
tumors, can shrink melanoma tumors and possibly prolong life as well. - Targeted therapy drugs target parts of melanoma cells that make them different from normal cells. These
drugs work differently from standard chemotherapy drugs. They may work in some cases when
chemotherapy doesn’t. They may also have less severe side effects.