May 17, 2018

It’s not something we see every day. Thankfully, ocular melanoma is extremely rare. But imagine going to your eye doctor for your annual eye check up and leaving with a diagnosis of cancer. This is exactly what happened to Vanessa.

“During my routine eye exam 11 years ago, Dr. Day found a growth on my left retina.”

For several years, the growth was monitored closely and it remained stable with no detectable changes in size or shape. Then, in 2010, using the latest technology in digital eye imaging, Dr. Day observed a change; the growth had increased in size.

“Dr. Day immediately referred me to see a trusted specialist,” Vanessa said. “I was examined and referred on to see a cancer specialist in Philadelphia, Pennsylvania.”

It was there that she received a diagnosis of melanoma of the retina.

What is Ocular Melanoma?

Most people think of Melanoma as skin cancer. But that is called cutaneous melanoma, while melanoma that occurs in the eye is called intraocular, or uveal melanoma.

Ocular melanoma is much less common than skin cancer. Skin cancer occurs in approximately 1 out of 50 Americans annually, while ocular melanoma occurs in approximately 6 people per million. Only 3-5% of all melanomas are found in the eye.

Vanessa’s cancer was even more unusual due to her age; she was just 29 at the time of her diagnosis.

Because of Dr. Day’s life-saving referral, “they were able to treat the cancer and I continue to follow up with a specialist to ensure that the tumor continues to shrink and to save my 20/20 vision,” she said.

Unlike skin cancer, patients are not able to self-monitor for changes like with an atypical mole or freckle, so ongoing monitoring for changes is essential.

Comprehensive Eye Exams

Your annual eye exam is about much more than just checking your vision for changes. In fact, most ocular cancers are discovered by an eye doctor during a routine eye exam.

Dr. Day uses special instruments to screen for ocular melanoma; sometimes he visualizes the retina with a microscope, or he may use a special camera or take detailed scans using Ocular Coherence Tomography (OCT).

Signs & Symptoms

Usually there are no symptoms associated with ocular melanoma but rare cases can present with:

• Visible dark spot(s) on the iris

• Blurred vision

• Seeing flashes of light

• Loss of vision or parts of vision

• Changes to the pupil shape or size

Treatment

Treatment typically includes plaque radiation and/or surgery. Surgery can include removal of the tumor alone, or in severe or late stage cases, the eye itself.

Prognosis

If ocular melanoma is suspected, it is important to begin intervention as soon as possible. Untreated melanoma of the eye can cause a host of other problems, including increased eye pressure, which can cause pain and vision loss.

Most problematic is the risk of metastasis; it is estimated that about half of ocular melanomas metastasize to other parts of the body, usually the liver.

Thankfully when caught early, ocular melanoma usually has a very high rate of full recovery.

Risk Factors

Factors that increase risk of melanoma:

• Fair skin, especially those who burn easily

• Light colored eyes

• History of atypical moles

• History of other types of cancer

Prevention & Screenings

Optometrists like Dr. Day are trained to screen for melanoma, as well as glaucoma, diabetes, macular degeneration, optic neuritis, and many other ocular disorders. Many of these disorders, like diabetic retinopathy, can point to other systemic issues that may otherwise go undiagnosed.

Other Melanomas

Plan to talk to your Primary Care Physician about any atypical moles or skin growths that you are concerned about.

• Have regular dental visits; your dentist will check the inside of your mouth for skin cancer.

• Take these words of advice from Vanessa: “Prevention is the best way to preserve your vision!”

• “I wanted to share my story with everyone – to everyone how truly important yearly eye exams are!”