Wherever your body produces melanin, you can have a freckle or a mole. Your eye is no exception! When a mole or freckle appears on your eye, the spot is called a nevus. Just like any dermatological concern, once you detect a nevus, you need to monitor the spot annually to make sure it does not develop into a type of cancer called ocular melanoma.
Dr. Lauren Agnew, OD, owner of Eye Wares, says a comprehensive eye exam creates a baseline to monitor possible signs of eye cancer. “If you have a nevus, don’t panic.” She says. “Think of your eye exam as something similar to a dermatological examination of a specific nevus. Only an eye doctor can discover a nevus in the back of your eye. Through a dilated exam or Optos photography, we can compare each years’ photos that are automatically saved to your chart. It’s important to have baselines when we monitor potential signs of ocular melanoma.”
How to Spot Ocular Melanoma
According to the Kellogg Eye Center, 5-10% of the population have at least one nevus, a non-harmful mole located on the eye. Most nevi are not dangerous, but a small percentage can develop into ocular melanoma. This risk increases along with the size and the location of the nevus. A nevus is not always visible unless you have a dilated exam or Optos photography, which is why regular eye exams are so important, especially if you have a family history of skin cancer.
Your optometrist will use either dilate or perform fundus photography (serial photographs taken of the interior of your eye) to detect and evaluate developing nevi. This is why, even if you have perfect vision, it is so important to schedule regular eye exams to monitor your vision as well as your eye health. And if the nevus is changing, it may be cancerous.
Treatment for Ocular Melanoma
Ocular melanoma is the most common variety of cancer in the eye in adults. It can lead to dangerous and even fatal complications if not identified and treated immediately. Specifically, ocular melanomas metastasize very quickly to the liver but are capable of spreading to any organ in the body. One of the questions Dr. Agnew hears most often is, “Why can’t you just surgically remove a nevus?”
“You don’t surgically remove a nevus unless it becomes an ocular melanoma. You can surgically remove eye melanomas, but our goal is to identify the ocular melanoma immediately, so the patient still has the chance to treat the cancer with radiation or laser therapy,” she says. “Cutting out an eye melanoma can result in a black spot in your vision and is considered a last resort.”
The following are the most common treatments for ocular melanoma:
- Radiation Therapy. A common treatment for eye melanoma, radiation therapy uses high-energy x-ray treatment to eliminate cancer cells.
- Laser Therapy. Transpupillary thermotherapy is primarily used to treat very small melanomas. The treatment heats and kills the tumor directly using infrared light.
- Surgery. Surgical removal of eye melanoma is typically considered necessary only when the eye has already been severely damaged by the tumor.
About Dr. Lauren Agnew
Dr. Agnew owns Eye Wares in Mandeville, Old Metairie, and Uptown, New Orleans (opening Fall 2021). She is a Louisiana native and a graduate of Tulane University. She completed her Doctor of Optometry degree at Southern College of Optometry and has been serving the Greater New Orleans community ever since.
Eye Wares has over 20 years of experience providing the Greater New Orleans area with friendly, advanced eye care services and fashionable independent and designer frames. You can schedule your eye exam online at EyeWaresNola.com. Most major insurance accepted.
