What is melanoma? Melanoma occurs when Melanocytes – the pigment-producing cells that give colour to the skin become cancerous. Melanomas can occur anywhere on the body, with the eye being the second most common site after the skin.
Signs may include a new, unusual growth or a change in an existing mole or naevus. Treatment may involve surgery, radiation, medication or in some cases, chemotherapy.
Ocular melanoma: As an optometrist, I frequently note pigmented spots and lesions in eyes of patients. These can range from benign iris freckles (small pigmented spots on the surface of the coloured part of the eye), through to large choroidal naevi (large moles situated beneath the retina at the back of the eye).
Posterior uveal melanoma- choroid and ciliary body: Being the most common site for ocular melanoma and occuring inside the eye, they are only detected during an eye examination. Symptoms may include blurred vision or blind spots, new floaters or flashes- however, these usually occur when the melanoma is well advanced.
Conjunctival melanoma: The conjunctiva is the delicate, vascularised tissue that overlays the sclera (white of the eye). Accounting for 10 percent of eye melanomas, treatment outcomes are favourable. However, recurrence is high so regular reviews are important.
Iris melanoma: Generally found during routine eye examinations and often occurring from pre-existing iris naevi- New Zealand has the highest known incidence in the world. If caught early, treatment options are favourable.
Risk factors
› Fair skin- although 4% of Uveal Melanoma in an Auckland Clinic occurred in Maori patients
› Light coloured eyes
› Having a pre-existing mole within the eye
› Ultraviolet light exposure
› Older age
Recommendations
› Wear sunglasses, ensuring they provide 100 percent UV protection. A hat is also beneficial to further shield ambient light exposure around the eye.
› My strongest recommendation would be to those who have never had an eye examination to book one! This enables the Optometrist to screen you for any risk factors of eye cancers and advise a time frame for any further reviews. As mentioned, as many of these lesions are not visible to the naked eye, it is only during a routine eye exam that they may be detected.
