Understanding Ocular Melanoma | Ultraviolet Awareness & Healthy Vision Month

Melanoma is a type of cancer usually associated with the skin. Did you know it also affects the eyes?
 
Ocular melanoma is a type of melanoma that  develops in the pigment cells in the eye.

According to the American Academy of Ophthalmology, although ocular melanoma is rare, it is the most frequent type of eye cancer in adults.

Ocular melanoma has been in the news recently. As such, for UV Awareness & Healthy Vision Month, we’re discussing the details of ocular melanoma, including symptoms, causes, treatment, and prevention.
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Symptoms of Ocular Melanoma

When melanoma affects the skin, an unusual sore, mole, or bump may be noticeable. But when it occurs in the eye, it’s not as easily noticed. In most cases, ocular melanoma develops in a part of the eye you cannot see.
 
In early stages of the disease, symptoms may not be present, which is another reason having regular eye exams is essential. When symptoms do occur, they may include a change in the shape of the pupil and a dark spot on the white of the eye. Some people may also develop a blind spot in their peripheral vision or a sensation of flashing lights.
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Causes of Ocular Melanoma

While the cause of ocular melanoma is not known, there are certain factors that appear to increase your the of developing the disease. According to the Ocular Melanoma Foundation, having prolonged exposure to ultraviolet light from the sun or a tanning bed increases risk of ocular melanoma. Additional risk factors include:

• Having light colored eyes
• Aging
• Being Caucasian

• Having dysplastic nevus syndrome, which is a skin condition that causes abnormal moles
  
• Increased pigmentation of the uvea, which is the middle layer of tissue beneath the white of the eye

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Treatment of Ocular Melanoma

The treatment recommended for ocular melanoma may vary depending on the size of the tumor. Treatment typically involves radiation therapy or surgery. In some cases, both are recommended.
 
Radiation Therapy
Radiation is often used to treat ocular melanoma. Different types of radiation therapy may be used, including eye-plaque brachytherapy and external proton beam therapy.
 
During brachytherapy, radioactive seeds are attached to a small disk called a plaque and placed next to the tumor on the wall of the eye. The radiation destroys the cancer cells. The nearby tissue is protected from the radiation by the plaque.
 
During proton beam therapy, a tube-shaped beam of radiation is aimed directly on the tumor through the front of the eye. This treatment allows eye cancer specialists to target the entire tumor and treat tumors that are either touching or surrounding the ocular nerve, while sparing surrounding healthy eye tissue and structures.
 
Radiation therapy to the eyes can have side effects, such as bleeding in the eye, cataracts, and damage to vision. Your eye doctor will discuss risks associated with radiation therapy and answer any questions you have.
 
Surgery
Surgery is also used to treat ocular melanoma. The extent of the surgery depends on the location and size of the tumor. It may involve removing the tumor and a small amount of healthy tissue around the mass.
 
If cancer has spread to the optic nerve or the tumor is large, surgery may involve removing the eye. If removal of the entire eye is needed, an implant is usually placed. The implant is attached to the eye muscle to allow for movement of an artificial eye. Once the tissue has healed, an artificial eye fits over the implant. Although vision is not possible through the artificial eye, it looks similar to the natural eye.
 
In some cases, ocular melanoma metastases, which means it spreads to other areas of the body. According to the Melanoma Research Foundation, when ocular melanoma metastasizes, it spreads to the liver about 90 percent of the time. Why the disease may spread specifically to the liver is not fully understood.
 
Treatment for ocular melanoma that has metastasized to the liver may involve a variety of palliative treatments, including surgery, radiation, and chemotherapy infused directly into the liver. Although the prognosis for metastatic ocular melanoma that has spread to the liver is poor, continued research and clinical trials offer hope that someday a cure for the disease will be found.
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Preventing Ocular Melanoma

Certain risk factors for ocular melanoma, such as increasing age and race, are not controllable. There are a few steps you can take to decrease your chances of developing this cancer though.
 
One of the most important things you can do to decrease your risk of developing ocular melanoma is to protect your eyes from UV rays. Always wear sunglasses when spending time outdoors. Make sure you select glasses that are labeled as providing 100 percent UVA and UBA protection. Wear eye-safe sunscreen around your eyes to decrease the risk of melanoma developing on your eyelids or around your eye. Consider using a stick sunscreen, which is less likely to get into the eyes and cause irritation. Adding a broad-brimmed hat when you’re out in the sun may also block the sun’s rays.
 
By protecting your eyes from UV rays, you decrease your risk of developing ocular melanoma. You also reduce your chances of macular degeneration and cataracts, which are also associated with sun exposure.
 
Although it won’t prevent ocular melanoma, getting regular eye exams is also vital. As with any type of cancer, early detection and treatment improve prognosis. Your eye doctor may be able to detect early signs of eye cancer and other conditions before you notice any symptoms.
 
If you have any questions about ocular melanoma, eye cancer treatment, or UV protection for your eyes or you would like to schedule an appointment with one of our eye doctors, please call our office at 508-746-8600.
 
We hope you found this information helpful. Please check back with us soon for “Healthy Vision & Contacts” as we wrap up Ultraviolet Awareness & Healthy Vision Month. Thanks for reading!