Intraocular Melanoma

• Intraocular Melanoma is the most common primary eye cancer in adults, arising from pigment-producing cells.
• Symptoms can be subtle or absent in early stages, often including blurred vision, floaters, or a dark spot on the iris.
• Risk factors include light eye color, fair skin, and certain genetic predispositions, though exact causes are unknown.
• Diagnosis relies on comprehensive eye exams and imaging, with prognosis depending heavily on tumor size and spread.
• Early detection is vital for preserving vision and improving long-term outcomes.

What is Intraocular Melanoma?

Intraocular Melanoma refers to a type of cancer that develops in the cells that produce pigment (melanocytes) within the eye. It is the most common primary intraocular malignancy in adults, though it remains a rare disease. This cancer primarily affects the uvea, the middle layer of the eye wall, which includes the iris (the colored part of the eye), the ciliary body (which produces fluid and helps with focusing), and the choroid (the layer of blood vessels that nourishes the retina). According to the American Academy of Ophthalmology, it affects approximately 5-6 people per million adults annually in the United States.

Unlike skin melanoma, which is often linked to sun exposure, the exact causes of intraocular melanoma are not fully understood. However, it is critical to distinguish this condition from other eye lesions, as timely diagnosis and treatment are essential for managing the disease and preserving vision.

Recognizing Intraocular Melanoma: Symptoms and Causes

Recognizing intraocular melanoma symptoms and signs can be challenging because the cancer often develops without noticeable symptoms in its early stages. Many individuals are diagnosed during routine eye examinations. When symptoms do occur, they can include:

• Blurred vision or a sudden change in vision.
• Flashes of light or the appearance of new floaters (small specks or cobwebs that drift across the field of vision).
• A dark spot on the iris or a change in the shape of the pupil.
• Loss of peripheral vision.
• Eye pain, though this is less common and usually indicates a more advanced stage.

The precise causes of intraocular melanoma eye cancer are not definitively known, but several risk factors have been identified. These include having light eye color (blue, green), fair skin, and a history of atypical moles. Certain genetic mutations, such as those in the BAP1 gene, are also associated with an increased risk. While excessive exposure to ultraviolet (UV) light is a known risk factor for skin melanoma, its direct link to intraocular melanoma is still debated and less clear. Age is another factor, with the risk generally increasing with advancing age.

Diagnosing Intraocular Melanoma and Understanding Prognosis

The process of intraocular melanoma diagnosis and prognosis typically begins with a comprehensive eye examination by an ophthalmologist. During the exam, the doctor may use specialized instruments to look inside the eye. Key diagnostic procedures include:

• Ophthalmoscopy: A dilated eye exam allows the doctor to view the back of the eye.
• Ocular Ultrasound: This imaging technique uses sound waves to create detailed pictures of the eye’s internal structures, helping to determine the size and location of the tumor.
• Fluorescein Angiography: A dye is injected into the bloodstream, and photographs are taken as it circulates through the eye’s blood vessels, highlighting abnormal areas.
• Optical Coherence Tomography (OCT): Provides high-resolution cross-sectional images of the retina and choroid.
• Biopsy: While less common for diagnosis due to potential risks, a small tissue sample may be taken if other tests are inconclusive.

The prognosis for intraocular melanoma largely depends on several factors, including the tumor’s size, its location within the eye, and whether it has spread beyond the eye. Early detection is crucial for better outcomes. For localized intraocular melanoma, the 5-year survival rate is approximately 80-85%, but this rate can decrease significantly if the cancer has metastasized, according to the National Cancer Institute. Regular follow-up examinations are essential after treatment to monitor for recurrence or metastasis.