Understanding Uveal Melanoma: A Rare but Serious Eye Cancer

Submitted by: Joshua Huang
Reviewed and approved by: Dr. Marie-Josée Aubin, Dr. Anne Xuan-Lan Nguyen

What is Uveal Melanoma?

Uveal melanoma (commonly referred to as ‘intraocular melanoma’) encompasses melanomas that arise in the iris, ciliary body, and choroid, all of which make up the uvea or uveal tract. The uvea is the second most common location for the development of melanoma, after the skin, and uveal melanoma is the most common primary intraocular cancer in adults. Although it is rare (it affects 5 adults out of 1 million people each year), it can lead to vision loss, eye loss and even death.

Symptoms

Although most patients are asymptomatic, symptoms can include:

• Blurry vision
• Flashes or photopsia
• Floaters or spots in your vision
• Visual field loss
• Visible dark spot on your iris
• Pain (uncommon)

Risk Factors

• Older individuals (peak age of 70)
• Existing skin moles,iris or choroidal nevi
• Fair skin and light eye colour
• Skin that burns easily with an inability to tan
• Arc welding
• Indoor suntan bed use
• Note: Although sunlight is a risk factor for cancers of the skin and the ocular surface, its association with uveal melanoma is controversial and has not been established

Diagnosis

1. Complete eye examination, including a dilated view of the back of the eye (fundus)
2. Ocular ultrasonography (B-scan)

Treatment Options

• Based on size and location
• Includes observation, resection, radiation therapy, or enucleation
• Immunotherapy if the cancer has spread (metastasis)

Conclusion

Despite advancing uveal melanoma treatment modalities, there has been no change in survival over the last 50 years. Therefore, awareness and prevention are critical to improving outcomes. talk to your doctor or eye care provider for a complete annual eye exam.