About Ocular Melanoma

Ocular melanoma – also sometimes called intraocular melanoma or uveal melanoma – is a rare eye cancer in the cells that are called melanocytes, which produce the pigment that colors the eyes.

The eye has three layers:

  1. The outer layer, which includes the white of the eye and the transparent cornea, where light enters.
  2. The inner layer, which is made up of the retina – a lining of nerve tissue that senses light entering the eye and sends images to the brain through the optic nerve.
  3. The middle layer, which is called the uvea or uveal tract. This middle layer is where ocular melanoma occurs.

The uvea has three main parts:

  • The iris, which is the colored area that is visible through the cornea. The pupil is in the center of the iris and changes size to let more or less light in.
  • The ciliary body, which is a ring of tissue and muscle that changes the size of the pupil and the shape of the eye’s lens. The ciliary body also makes a clear fluid that fills the space between the cornea and iris. 
  • The choroid, which is a layer of blood vessels that supply the eye with oxygen and nutrients. Most ocular melanoma occurs in the choroid.

Ocular melanoma of the choroid or ciliary body is often larger than melanoma that appears in the iris. It also is more likely to spread to other parts of the body. When melanoma occurs in the iris, it usually is a small tumor that grows slowly.

Though rare, ocular melanoma is the most frequently diagnosed primary eye cancer among adults. The median age at diagnosis is 56, although the relative risk increases with age.

There is no such thing as a routine ocular melanoma. Every patient’s disease is different, with different, individually unique genes and molecules driving that specific cancer.

At the OSUCCC – James, our ocular melanoma sub-specialists are world-renowned cancer experts who focus solely on these tumors and who reach across medical disciplines (ocular oncologists, medical oncologists, surgical oncologists, radiation oncologists, dermatologists, pathologists, geneticists, pharmacists, nurse sub-specialists and more) to design the very best treatment plan and therapies to target each patient’s specific cancer.

In fact, our unique Multidisciplinary Melanoma Clinic offers all newly diagnosed ocular melanoma patients an on-site, thorough evaluation and treatment-options review with experts from ophthalmology, radiation oncology, surgical oncology, medical oncology, neuro oncology and dermatology so that together, the patient and the experts can decide on the best personalized treatment options.

Additionally, patients have access to advanced treatment procedures performed only at the OSUCCC – James by internationally recognized experts in ocular melanoma.

And by offering access to the country’s most advanced clinical trials right here at the OSUCCC – James, patients know that additional options, when needed, are often available for their treatment and care.

(Source: National Cancer Institute)

Ocular Melanoma Anatomy

Types of Ocular Melanoma

Ocular melanoma has been classified into different stages using the international AJCC staging classification. The tumor is classified as category 1-4 depending on size, location, and other factors. The AJCC stage offers information about patient prognosis.

Now, ocular melanoma can be further classified by genetic risk factors which predict whether the tumor will be more or less aggressive. These factors include chromosomal abnormalities like monosomy 3 and gain of 8q which are associated with aggressive tumors. These abnormalities are very important for prognosis and determining risk of metastasis. Specific mutations in genes including BAP1, SF3B1, EIFAX1, GNAQ, GNA11, CYSLTR2, PLCB4, and others have clinical importance. For example, BAP1 predisposes to high risk for metastasis. In addition, three gene expression classification profiles (class 1A, 1B, and 2) are also very effective in assessing the prognosis of the tumor. Genetic prognostic information (if available) is used together with AJCC staging information to assess the overall level of risk and cancer monitoring plan. Your OSUCCC – James specialists will further identify and diagnose ocular melanoma according to these categories.

(Source: National Cancer Institute)

Ocular Melanoma Symptoms

Ocular melanoma symptoms can include blurred vision or a dark spot on the iris, but the disease may not cause any early symptoms. It is sometimes found during a regular eye exam when the doctor dilates the pupil and looks into the eye.

Other symptoms can included:

  • Changes in vision
  • Floaters (spots that drift in your field of vision) or flashes of light
  • A shadow or new blind spot in the vision
  • A change in the size or shape of the pupil
  • A change in the position of the eyeball in the eye socket

(Source: National Cancer Institute)

Having these symptoms does not necessarily mean you have ocular melanoma. But if you have symptoms, you should tell your doctor, especially if symptoms have continued for longer than a few weeks.

If you’ve been diagnosed with ocular melanoma, would like a second opinion or would like to speak with a melanoma specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

460 West 10th Avenue

Columbus, Ohio 43210


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