Melanoma is a serious form of skin cancer that can strike in unexpected places—including the eye.

Melanoma of the eye, also called ocular or uveal melanoma, arises in the uveal tract of the eye. The uveal tract includes the iris (the colored part of the eye), the muscles that change the size of the pupil and shape of the lens (ciliary body), and the layer of blood vessels (choroid) that supports the eye. The choroid is the most common site in the eye for melanoma. People with this cancer are at increased risk for developing other types of cancer, especially in the first year after diagnosis. Fortunately, melanoma of the eye is rare; there are only 1,200 to 1,500 cases per year in the U.S.

If you have melanoma of the eye, you probably have few, if any, signs. The most common symptom is a dark spot on the iris or blurred vision. Most people learn they have melanoma during a routine eye exam.

Treatment of Ocular Melanoma

The primary goal in treating melanoma of the eye is to stop the growth of cancer cells, reduce the risk the tumor will spread, and preserve the patient's vision and appearance as much as possible. Treatment varies depending on the size of the tumor and where it is, as well as the patient's health, age, visual potential, and status of the other eye.

Traditionally, the most prevalent treatment was to remove the eye surgically—called enucleation. Today, surgery is still common, however, when possible, physicians just remove the local tumor and spare the eye.

Radiation therapy—high doses of local radiation targeted just to the tumor—minimizes damage to surrounding tissue and is now the most frequently used option to treat melanoma of the eye. Physicians also use photocoagulation, a big word that describes using laser light to destroy blood vessels that supply nutrients to the tumor, or thermotherapy, using heat to destroy cancer cells. For some patients, especially those who are older and have a limited life expectancy, physicians may just monitor the melanoma and not necessarily treat it. Targeted molecular therapy is showing promise and may become another non-invasive type of treatment.

There's another bit of good news for patients. There are two types of melanoma of the eye. They are genetically different—one has a low risk of spreading, the other a high risk. With a simple biopsy, physicians can now determine which type of melanoma patients have so they can closely monitor those patients at highest risk.

Sources:

National Cancer Institute. "Intraocular (Eye) Melanoma Treatment (PDQ)." Web. 25 June 2008. http://www.cancer.gov/cancertopics/pdq/treatment/intraocularmelanoma

Freedman, Michal D., Miller, Barry A., and Tucker, Margaret A. "New Malignancies Following Melanoma of the Skin, Eye Melanoma, and Non-melanoma Eye Cancer." NEW MALIGNANCIES AMONG CANCER SURVIVORS: SEER CANCER REGISTRIES, 1973-2000. Web. http://seer.cancer.gov/publications/mpmono/Ch13_Melanoma.pdf

Ramaiya, Kamalesh J., and Harbour, J. William. "Current Management of Uveal Melanoma." Expert Review of Ophthalmology 2(6) (2007):939-946. Web. 9 January 2008. http://www.medscape.com/viewarticle/568460