Let's Talk about Ocular Melanoma

Going to the eye doctor is a mixed bag for me. I love getting better eyesight and new, fashionable frames. Eyeglasses have come a long way since the 1970’s when we had eight pound lenses. I don’t mind the eye test and trying to figure out which prescription is best when they all look the same to me. You know the deal when the ophthalmologist asks “is this better or is this better?” They all look better to me!

I was concerned about cancer of the eye

I’m not a big fan of the air puff test looking for glaucoma. I hate keeping my eye open. Eventually, I get to the part of the exam where the doctor asks me questions. I now have what are called “floaters”. This is a condition where little floating squiggly dots move around my field of vision. At first, I was concerned about this. With my history of melanoma, I was concerned about cancer of the eye. I had heard of ocular melanoma, but had no idea what it was.

I asked my doctor about ocular melanoma

So, I asked about melanoma of the eye. My doctor said that he regularly checks for this during his exam. Since he is able to see into my brain with that scope, I have always assumed he could find melanoma if it was hiding in there. He proceeded to ask if I was having flashing sensations in my vision. I said that I had not and only had those floaters. He told me that the floaters were normal for a person of my age. (thanks for that). According to my doctor, one of the symptoms of melanoma of the eye is flashing.

What else should we look for?

This made me curious about what other symptoms I should look out for. Recently, a New England Journal of Medicine article reported that a woman from China had been diagnosed with cancer that was actually around her eyelid.¹ She had experienced intense itching not attributable “pink eye” ,also known as conjunctivitis. The woman refused surgery and underwent treatment with pembrolizumab. According to the study, the lesion has not expanded. So, cancer can occur in the eye AND around it. What should we look out for?

Eyelid cancer symptoms:²

• Bumps that bleed
• Any crusty, scaly brown or red patches or lesions
• A sty that will not heal
• Losing eyelashes

Eyeball cancer symptoms:³

• Vision problems (sudden loss or blurry)
• Peripheral vision loss
• Growing dark spot on the colored part of the eye (iris)
• Change in the size and shape of the pupil
• Change is the size of the eye or way it moves
• Interesting to note that pain is not common unless the cancer has grown outside the eye itself.

So, melanoma can attack the eyelid and the eye itself!

This leads me to these two important considerations:

It is critical to get your eyes checked, not just for a change in vision but for signs for disease. Melanoma is tricky and your eye doctor can find things that you can’t. Also, wearing eyeglasses and sunglasses that have a UV protective coating is a good way to protect your eyes when out in the sun. They are easy to find at most optical stores and can make a huge difference.

How do you protect your eyes? Did you previously know the signs and symptoms of ocular melanoma?