Melanoma

Treatment of Ocular Melanoma

Cells that produce melanin pigment are found in the conjunctiva (the delicate tissue covering the eye) and inside the eye in the vascular support tissue called the uveal tract. In ocular melanoma, these pigment-producing cells may give rise to malignant cells. Melanoma grows less frequently in ocular tissue than in other skin tissue.

Tumors in the eyes resist treatment more than melanomas arising on the skin. Identifying and treating ocular melanoma as early as possible are essential.

The primary treatment for conjunctival melanoma is surgical excision (removal). In rare instances topical chemotherapy may be used. The treatment of choice for uveal melanoma depends upon the size of the tumor.

Small uveal melanomas are sometimes observed for evidence of growth before physicians recommend treatment. When small melanomas exhibit growth, they are sometimes treated with an infrared laser. The laser is often used in combination with other treatments, such as radiotherapy or cryotherapy.

Medium-sized uveal tumors are often treated with radiotherapy using radioactive seeds. Specialists place seeds in a small plaque that looks something like a bottle cap, and sew it on the wall of the eye directly over the location of the tumor. This remains in place for several days before it is removed.

Massive uveal melanomas too large to be treated with radiation are generally managed by removing the eye.

The signs and symptoms of ocular melanoma include:

Conjunctival melanoma:

• Increased pigmentation of the conjunctiva in Caucasians, particularly if the increased pigmentation is limited to one eye
• Localized thickening of a pigmented area of the conjunctiva

Uveal (choroidal) melanoma:

• Often uveal melanomas cause no symptoms and are found during a routine eye examination
• Increased pigmentation and thickening of an area of the iris
• Decreased or distorted vision in one eye