CHOROIDAL MELANOMA

Tumors arise from the pigment cells that reside within the uvea and give rise to eye color. When eye melanoma is spread to distant parts of the body, the five-year survival rate is about 15%.

This is the most common type of primary eye cancer. Males and females are affected equally. Worldwide, there are around 2 million to 8 million cases per year.More than 50% metastasize, mostly to the liver.

Ocular melanoma may present without symptoms depending upon the location and size of the tumor. When symptoms do occur, they can include:^[

• blurred vision
• double vision 
• irritation
• pain
• a perception of flashes of light in the eye 
• a reduction in the total field of vision
• loss of vision
• a sensation of a foreign body in the field of vision (floaters)
• redness, bulging or displacement of the eye (proptosis)
• a change in the shape of the pupil
• pressure within the eye
• distortion of vision where, when a person looks at a grid of straight lines, the lines may appear wavy and parts of the grid may appear blank.

The treatment protocol for uveal melanoma has been directed by many clinical studies, the most important being The Collaborative Ocular Melanoma Study (COMS).The treatment varies depending upon many factors, chief among them the size of the tumor and results from testing of biopsied material from the tumor. Primary treatment can involve removal of the affected eye. However, this is now reserved for cases of extreme tumor burden or other secondary problems. Advances in radiation therapies have significantly decreased the number of patients treated by eye removal/ enucleation

Author

Paddy Kalish OD, JD and B.Arch