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Melanoma develops in the cells that produce melanin — the pigment that gives your skin its color. Your eyes also have melanin-producing cells and can develop melanoma. Eye melanoma is also called ocular melanoma. Melanoma that originates in your eye is termed a primary eye cancer. Eye melanoma is the most common type of primary eye cancer in adults, but it's rare. If the melanoma begins elsewhere, such as your lung or breast, and then spreads to your eye, it's called a secondary eye cancer. Treatment is available for eye melanoma, and the earlier it's detected, the better your chance for successful treatment. Getting regular eye exams can help your doctor detect eye melanoma at an earlier stage.
Alternative Names of Eye Cancer are: Eye Melanoma.
Causes of Eye Cancer
Signs & Symptoms of Eye Cancer
You may experience no symptoms at all for melanoma of the eye. On the other hand, eye melanomas may cause light flashes, blurring or a dark spot in your vision.
Signs and symptoms to watch for include:
Diagnosis of Eye Cancer
Having a regular examination of your eyes by a physician eye specialist (ophthalmologist) is the first and most important step in early detection and diagnosis of eye melanoma. Your doctor will examine the outside of your eye, looking for enlarged blood vessels that can indicate a tumor inside your eye. Then, with the help of instruments, your doctor will look inside your eye. One method, called ophthalmoscopy, uses lenses and a bright light mounted on your doctor's forehead — a bit like a miner's lamp. Another method, called slit-lamp biomicroscopy, uses a microscope that produces an intense beam or line of light to illuminate the interior of your eye. In most cases, looking inside your eye alone will be enough to detect and diagnose any tumors or other abnormalities.
Further evaluation of suspected melanoma
If your doctor suspects you may have eye melanoma; you may undergo one of a number of imaging tests:
Treatments of Eye Cancer
After eye melanoma is diagnosed, you and your doctor will review your treatment options. Factors to be considered are the location and size of the melanoma, as well as your overall physical health. Some doctors may also consider the genetics of the tumor (cytogenetics) when deciding on the best treatment course. However, this is a topic currently being debated in the medical community and some experts feel that more studies are needed to determine the best type of profiling for predicting tumor behavior and outcomes. Melanomas of the eye are rare, so it's a good idea to find a doctor with experience in treating these cancers. In addition, a second opinion can provide more information and help you feel more confident about your treatment plan. Sometimes, doctors suggest observing a small lesion rather than treating it right away. But your doctor will generally recommend treatment for a medium-sized or large-sized melanoma. Treatment designed to destroy a melanoma often will cause some loss of vision, even though every effort is made to preserve vision. But because cancers of the eye can be fatal, in some cases you'll need treatment even if it means loss of vision or loss of your eye. Surgery is the foundation for most eye cancer treatments. If an eye melanoma is of a certain size and in a favorable location, treatment can sometimes be accomplished with surgery alone. Treatment for other eye melanomas may be done with radiation alone, or radiation combined with a therapy such as infrared laser.
Depending on the characteristics of the tumor, your doctor may choose from a variety of surgical procedures to remove the melanoma:
Carefully targeted and regulated doses of high-energy radiation — radiation therapy — can destroy ocular melanoma and be lifesaving. Radiation therapy damages cells by destroying the genetic material that controls how cells grow and divide. And although both healthy and cancerous cells are damaged by radiation, the goal of treatment is to hurt as few normal, healthy cells as possible. Doctors generally reserve radiation treatment for eye melanomas to medium-sized and large-sized melanomas, although selected small-sized melanomas may sometimes be treated with radiation. The radiation dose can be delivered with charged particles such as proton beams, which are generated from outside of your body and directed into your eye (teletherapy). Or, the radiation can come from small radioactive seeds that are temporarily anchored to your eye (brachytherapy). In brachytherapy, a small implant (plaque) similar to a bottle cap and containing several radioactive seeds (usually iodine 125 seeds) is sutured to the wall of your eye at a site overlying the tumor. The plaque remains in place for four to five days until it has delivered an optimal amount of radiation for the characteristics of your tumor. The device is then removed, and your doctor will monitor the tumor at regular intervals to watch for tumor shrinkage.
Small eye melanomas
There has been a recent trend toward treating small eye melanomas with either radiation therapy or transpupillary thermotherapy (TTT) — a type of infrared laser therapy — or both. Destroying the cancerous tissue by freezing it (cryotherapy) also has been used for some small eye melanomas.
Prevention of Eye Cancer
While no direct link has been established between sun exposure and eye melanoma, an association has been found. Because of this, some doctors recommend regular use of UV-blocking sunglasses as a possible preventive measure.
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