Melanoma of the eye

Proven content

Melanoma of the eye is a malignant intraocular neoplasm that often arises from genetic causes and as a result of UVA and UVB radiation. People with light skin and the iris of the eye, exposed to sunburn, are at increased risk. Melanoma of the eye shows different symptoms depending on where it appeared.

What is eye melanoma?

Melanoma of the eye is a rare malignant neoplasm considered to be the most common extra-cutaneous localization of melanoma, it originates from mutated pigment cells. The cause of its occurrence is most often the tendency to family inheritance and exposure to UV radiation. People with a naturally fair complexion have a predisposition to skin burns, and thus belong to the group of increased risk of eye melanoma. The ailment usually affects the choroid of the eye, which manifests itself with defects in the field of vision, pain and irritation. Melanoma usually does not give any symptoms and is very often diagnosed during an accidental medical consultation.

Causes of eye melanoma

The main causes of eye melanoma are listed below.

1. Cancer in the form of eye melanoma usually appears where there are many pigment cells: the ciliary body, the choroid or the iris.

2. Melanoma of the eye is most often caused by genetic predisposition, especially if the relatives of the first degree suffered from melanoma.

3. Exposure to UVA and UVB radiation.

4. People whose skin is often sunburned, i.e. those with fair complexion, are much more likely to develop melanoma. They have over thirty pigmented marks.

5. Smokers are also exposed to melanoma.

Important! Pigment cells can attack other parts of the body as well, not necessarily those that are exposed to sunlight. So melanoma doesn’t just arise in the eye.

Melanoma of the eye – symptoms and types

The symptoms of eye melanoma depend on where the cancer has started. However, one thing in common is visual field defects and the vision of indeterminate “luminous spheres” after dark.

1. Iris melanoma: We observe a light to dark brown lump that may be distorting the pupil. Iris melanoma is very easily noticeable for both the patient and other people. The lump is more visible in people with a blue iris, it gradually increases in size and sometimes distorts the pupil. At first, the patient does not feel any pain or problems with visual acuity.
2. Ciliary body melanoma: no visible symptoms until visual disturbance and eye pain develop. It is the rarest type of eye melanoma, which remains invisible without specialist examination.
3. Choroidal melanoma: the most common form of eye melanoma located at the back of the eye, so symptoms only appear when it begins to affect the work of the retina – visual acuity and visual field disturbances appear.

Melanoma of the eye – diagnosis

Melanoma of the eye is diagnosed on the basis of the results of slit-lamp examinations and ultrasound. The type of research is selected on a case-by-case basis. Imaging tests include:

1. ultrasound examination – allowing to determine the extent of the tumor;
2. magnetic resonance imaging – performed in order to correctly assess the eye socket and eyeball;
3. routine chest X-ray examination.

In addition, diagnostics are carried out for possible metastases (if they are not present in the liver, then they are probably not present in other locations as well).

The final diagnosis of eye melanoma is based on the histopathological examination of the material removed during the biopsy. The taken fragment is assessed under a light microscope and additional tests are performed if necessary. The treatment of a malignant tumor consists in removing the eyeball or the entire eye socket, which is then refilled with an eye prosthesis.

Melanoma of the eye – treatment

The doctor starts treatment based on the size and location of the malignant melanoma. As mentioned above, in the case of a malignant tumor, the eyeball or the entire content of the orbit is removed to then insert an eye prosthesis. If the tumor size is not large, other treatment methods are used, for example:

1. external irradiation;
2. teleradiotherapy;
3. local intraocular excision;
4. radiation therapy with radioactive plates with iridium, ruthenium or iodine;
5. argon laser coagulation;
6. treatment with a proton cyclotron and helium ions.

Doctors use chemotherapy and immunotherapy as complementary therapy. Chemotherapy is given to patients with metastatic melanoma to the liver or other parts of the body.

Eye melanoma – what is the prognosis?

The prognosis of eye melanoma depends on the location of the tumor, its histopathological type and size. This tumor produces metastases that can attack:

1. the liver;
2. kidneys;
3. lungs;
4. lymph nodes;
5. brain;
6. digestive system.

Prevention

As with any disease, prevention plays an important role. Everyone (even people who do not have vision problems) should visit an ophthalmologist at least once a year to conduct specialist eye examinations. It is also worth investing in good glasses (preferably at an optician) with appropriate filters that will partially or completely protect our eyesight from harmful radiation. The most important rule is to adjust the glasses to the face so that the light does not enter the eyes sideways. Contrary to appearances, sunglasses with filters are also recommended in winter, because the light reflecting off the snow is very sharp and can harm our eyes.

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