Uveal melanoma is a rare but serious type of eye cancer that originates in the uvea, the middle layer of the eye. It is the most common primary intraocular cancer in adults and develops from pigment-producing cells called melanocytes. If left untreated, it can spread to other parts of the body, particularly the liver.
Uveal melanoma arises when melanocytes in the eye undergo genetic mutations, leading to uncontrolled cell growth and tumor formation. The uvea consists of three parts:
Iris – The colored part of the eye.
Ciliary body – The structure involved in eye fluid production and lens control.
Choroid – The vascular layer that supplies nutrients to the retina.
Most uveal melanomas develop in the choroid, followed by the ciliary body and iris.
Originates in the uvea – Affects the iris, ciliary body, or choroid.
Most common intraocular cancer in adults – Though rare, it requires immediate medical attention.
Can spread (metastasize) – Often spreads to the liver if untreated.
Early detection is crucial – Routine eye exams aid in early diagnosis.
The exact cause of uveal melanoma is unknown, but several factors increase the risk of developing this cancer.
Age and Gender – More common in older adults and slightly more prevalent in men.
Light Eye Color – People with blue or green eyes have a higher risk.
Fair Skin – Less melanin increases susceptibility.
Excessive Sunlight Exposure – UV radiation may contribute to melanoma development.
Genetic Mutations – BAP1 gene mutations increase the risk.
Family History – Having a relative with uveal melanoma raises the likelihood.
Atypical Nevi (Moles) – Unusual moles in or around the eye may be linked to higher risk.
Early-stage uveal melanoma often has no symptoms. As the tumor grows, the following signs may appear:
Blurred or distorted vision – Affects one eye.
Dark spot on the iris – A visible pigmented lesion.
Flashes or floaters – Sudden light flashes or spots in vision.
Peripheral vision loss – Gradual narrowing of vision.
Change in pupil shape – Irregular or enlarged pupil.
Eye pain or discomfort – May occur in advanced stages.
Uveal melanoma is classified based on its location in the eye.
Iris Melanoma
Typically slow-growing and diagnosed early.
Less likely to spread compared to other types.
Ciliary Body Melanoma
More aggressive and harder to detect.
Can lead to increased eye pressure (glaucoma).
Choroidal Melanoma
The most common type.
Has a higher risk of metastasis, especially to the liver.
Several tests help diagnose and determine the stage of uveal melanoma.
Dilated Eye Exam – A detailed examination of the retina and choroid.
Ultrasound of the Eye – Uses sound waves to detect tumor size and location.
Optical Coherence Tomography (OCT) – Provides cross-sectional images of the eye.
Fluorescein Angiography – Uses a dye to examine blood vessels in the eye.
Biopsy (Rarely Needed) – Tissue sampling may be performed in uncertain cases.
MRI or CT Scans – Checks for cancer spread to other organs.
Treatment depends on the tumor’s size, location, and whether it has spread.
Plaque Brachytherapy – Radioactive plaque is placed near the tumor.
External Beam Radiation (Proton Therapy) – Targets the tumor with high precision.
Local Tumor Resection – Removal of the tumor while preserving vision.
Enucleation – Complete removal of the eye in large or aggressive tumors.
Transpupillary Thermotherapy (TTT) – Uses infrared laser to destroy small tumors.
Targeted Therapy – Focuses on specific mutations in cancer cells.
Immunotherapy – Helps the immune system attack cancer cells.
Chemotherapy – Used if cancer has spread beyond the eye.
The prognosis for uveal melanoma depends on early detection and treatment.
Localized Tumor – 80-90% five-year survival rate.
Metastatic Disease (Spread to Liver) – Drops significantly to 10-20%.
Tumor Size and Location – Larger tumors have a higher risk of spread.
Genetic Mutations – BAP1 mutations indicate a worse prognosis.
Liver Metastasis – Most common site of cancer spread, impacting survival rates.
Early Detection and Treatment – Improves outcomes significantly.
While uveal melanoma cannot always be prevented, certain measures may reduce risk.
Routine Eye Exams – Helps detect early changes.
UV Protection – Wear sunglasses with UV protection.
Avoid Excessive Sunlight Exposure – Reduce exposure to direct sunlight.
Healthy Lifestyle – Maintain a balanced diet and avoid smoking.
Genetic Testing – Consider testing if there is a family history of uveal melanoma.
Coping with uveal melanoma involves ongoing medical care and lifestyle adjustments.
Regular Follow-ups – Frequent eye exams and imaging to monitor recurrence.
Psychological Support – Counseling or support groups for emotional well-being.
Vision Rehabilitation – Adaptive devices for vision impairment.
Healthy Diet and Exercise – Supports overall health and immune function.