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Melanoma in the Eye: Symptoms, Diagnosis & Treatment

Its meaning melanoma we have mainly associated it with skin cancer.

Can melanoma also appear in the eye? Unfortunately it can, it is the tumor in the eye that concerns adults, it is called ocular melanoma and it has to do with a form of cancer of the pigment tissues of the eye. It almost always starts in the eye and in extremely rare cases it can metastasize to the eye from another part of the body.

Ocular melanoma almost always concerns one eye, it is a potential cancer and of course, as is the case with other forms of cancer in other parts of the body, immediate diagnosis, timely and correct treatment are very important. Eye cancer is an extremely rare form of cancer, approx 6 cases per million and the factors associated with its occurrence are still largely unknown. It appears mainly during the sixth decade of a person’s life.

In which areas of the eye can someone develop melanoma?

Melanoma can appear in the following areas of the eye:

  • Conjunctival melanoma. In this case it happens on the surface of the eye.
  • Choroidal melanoma. In this case it happens in the inner part of the eye, which includes the iris and the ciliary body, which is responsible for producing fluid inside the eye and a key helper in controlling the movement of the lens. Or in the choroid, the layer of tissue between the retina and the sclera.
  • Melanoma on the eyelid.
  • Melanoma in the eye socket.

What are the symptoms of ocular melanoma on the conjunctiva?

Melanoma is an aggressive form of cancer and can spread quickly. If the melanoma is located on the conjunctiva or iris the signs are:

  • Something dark brown or black mark in the conjunctiva, i.e. the covering of the eye.
  • Something eye mark which either changes shape and grows, or changes color over time.
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What are the symptoms of choroidal melanoma?

Sometimes ciliary body melanoma or choroidal melanoma can be without any symptoms at all. If it gives symptoms they are the following:

  • Some dark or black spot in the iris of the eye.
  • THE intense redness in the eye.
  • THE noticeable pain in the eye.
  • THE swelling in the eye.
  • THE reduced – blurred vision.
  • THE loss of vision.
  • A feeling of flickering light.
  • The deformation of objects, metamorphosis.
  • Some defects in the visual field.
  • Flashes.
  • THE change in color of the iris of the eye.

How is melanoma in the eye diagnosed?

If you have even the slightest suspicion of melanoma in the eye, don’t waste a minute and visit your eye doctor immediately. The specialist doctor will examine with the ophthalmoscope scrutinizing and in every detail the eye, he will probably proceed with a fluoangiography, he will continue with optical coherence tomography OCT, with some ultrasound of the eye, with axial or even magnetic resonance imaging of the eye socket. If there is also a parallel damage to the skin, a skin biopsy is also performed.

What factors increase the risk of developing melanoma in the eye?

  • The people who have nebula in the eyes are at greater risk of developing ocular melanoma.
  • The most important factor responsible for the occurrence of melanoma in the eye is overexposure to age radiation.
  • Those who have light skin color and light eye color are more prone to developing ocular melanoma.

How is ocular melanoma treated?

First at this point let us clarify that the treatment depends on some basic parameters:

  • The position of ocular melanoma.
  • The size of melanoma.
  • Visual acuity of the affected eye.
  • Condition of the unaffected eye.
  • The general state of health of the patient.
  • The age of the patient.

Small tumors, which are stable and do not grow and which of course do not cause vision problems, may be systematically observed by the specialist ophthalmologist, without the latter undertaking an immediate treatment.

Surgery

Ocular melanomas that have appeared on the conjunctiva are removed in the majority of cases with surgery. Cryotherapy is applied to the area around the tumor, a cooling process with the aim of completely destroying any remaining cancer cells in the area.

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Small ocular melanomas in the iris, choroid, and ciliary body are also most likely to be surgically removed and treated. A pioneering way to treat choroidal melanoma involves its intrabulbar removal. During said surgery, the jelly of the eye is removed, vitrectomy. When the retina is artificially detached and the tumor is revealed, then it is removed with a special tool up to the healthy borders of the choroid and up to the white sclera that is under the choroid.

Retinochoroidectomy

A variant of choroidectomy is the technique of retinochoroidectomy, where here the retina is removed together with the tumor, when there is its infiltration over the melanoma.

The advantages of this particular method are the preservation of the eyeball and above all the preservation of the patient’s vision in order for the melanoma patient to have the best possible quality of life after the end of the surgery. This method is recommended even for large tumors, which are located in the central areas of the fundus of the eye and are threatening even for loss of vision.

The material taken by the specialized ophthalmologists during the surgical removal of the tumor is studied histologically in order to more accurately diagnose and type the melanoma. It is also studied genetically, where experts identify the melanoma genes that are statistically associated with the risk of metastases.

Proton beam radiation

THE proton beam radiation is a pioneering technique for the treatment of ocular melanoma with. This method has saved the sight of many patients and it was first applied in 1975 by the Greek professor of ophthalmology at Harvard University in the USA. Evangelos Gragoudas.

The ophthalmologist Mr. Evangelos Gragoudas himself explains why the treatment of melanoma in the eye with proton beam radiation is superior to radiation with radiotherapeutic plates. This is because with proton beam radiation a homogeneous dose of radiation is achieved throughout the volume and at the same time the surrounding tissues are fully protected. The professor points out that the treatment only takes 2 minutes and the patient needs to repeat it 5 times. Then he is simply monitored by his doctor. The success rate has been calculated at 97%.

Other methods

Dealing with laser, laser photocoagulation and intercortical thermotherapy are other methods that the ophthalmologist may turn to in order to remove, treat, and ultimately cure small growing tumors.

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In the worst case when the tumor is large in size, has affected other parts of the eye and none of the above methods of treating ocular melanoma are sufficient, then we conclude perhaps removing the eye.

Melanoma in the eye most often does not respond well in chemotherapy.

Which eye color is associated with an increased risk for ocular melanoma?

The color of the eyes, as revealed by an American study may constitute predisposing factor for eye cancer. This study shows the association between the genes that determine eye color and the occurrence of melanoma in the eye area.

The researchers based on 29 inherited gene mutations that have been linked to skin cancer to determine if and to what extent they also play a role in ocular melanoma. They concluded that some genes responsible for eye color are associated with an increased risk of melanoma in the eye. Specifically the analysis indicates that 5 mutations are associated with ocular melanoma and 3 most important of them they are located in the part of the genetic code responsible for eye color.

The same researchers concluded that people with blue, gray and green eyes combined with light skin color are more likely to get sick and get eye cancer than the rest.

What is the proper prevention of melanoma in the eye?

It is clearly better to prevent a disease than to have to deal with it. Below you will find some useful tips to avoid the appearance of melanoma in the eye.

  • It’s good avoid the sun, which is otherwise beneficial for your body between the hours of 12:00 pm and 2:00 pm where the rays are vertical and extremely intense. Excessive and reckless exposure to the sun ceases to be beneficial.
  • Always remember wear sunglasses winter – summer that have 100% protection from ultraviolet solar radiation.
  • Don’t neglect for no reason your annual eye exams. A simple routine examination can show if something is wrong and save you from worse and more painful situations.

The information in our articles is not intended to replace a relationship with a qualified healthcare professional, physician or medical advisor, and is not intended as medical advice.

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