Melanoma Of Eye: Causes, Symptoms, Risk Factors, Diagnosis, Treatment And Complications

Melanoma is a type of cancer that develops in the cells that make melanin, the pigment that gives your skin its color. Since melanin-producing cells are also found in the eyes, melanoma may develop there. Another term for eye melanoma is ocular melanoma.

Most ocular melanomas form in the portion of the eye that is not visible in a mirror. This complicates the diagnosis of ocular melanoma. In addition, there are typically no early warning signs or symptoms of eye melanoma.

Treatments exist for ocular melanomas. Treatment for some tiny ocular melanomas might not have an impact on your vision. However, during treatment, the majority of big ocular melanomas necessitate some degree of vision loss.

Causes Of Melanoma Of Eye

Eye melanoma's precise cause is uncertain.Medical professionals are aware that eye melanoma can arise from errors in the DNA of healthy eye cells. Because of DNA errors that direct the cells to multiply and flourish uncontrollably, the mutant cells live on when they ought to die. When mutated cells accumulate in the eye, an ocular melanoma results.

Eye melanoma most often starts in the cells of the uvea, the central layer of the eye. There are three parts of the uvea that can be affected by eye melanoma:

• The iris is the coloured area on the front of the eye.
• The choroid layer is the layer of connective tissue and blood vessels at the back of the uvea that sits between the retina and the sclera.
• The ciliary body, situated in front of the uvea, secretes the translucent substance called aqueous humor into the eye.

These types of eye melanoma can also appear on the conjunctiva, the outermost layer of the front of the eye, the eyeball socket, or the eyelid, despite the fact that they are quite rare.

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Symptoms Of Melanoma Of Eye

Eye melanoma may present with no symptoms at all. When they do manifest, signs and symptoms of eye melanoma may include the following:

• A sensation that there are flashes or dust particles in your area of view
• A growing black patch on the iris a change in the shape of the pupil, or a dark circle, in the center of your eye
• The vision in one eye is blurry or poor.
• Reduced vision in the periphery.

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Risk Factors  Of Melanoma Of Eye

The subsequent factors are associated with an increased risk of primary ocular melanoma:

• The pale color of the eyes: Eye melanoma is more common in those with green or blue eyes.
• White skin color: White individuals have a higher risk of developing eye melanoma than those of other races.
• Age: An increased age increases the risk of eye melanoma.
• Several inherited skin diseases: Dysplastic nevus syndrome, a disorder that causes abnormal moles, may raise your risk of developing melanoma on your skin and in your eyes. Furthermore, people with elevated pigmentation on the uvea, a condition known as uveitis, and aberrant skin pigmentation affecting the eyelids and surrounding tissues have a higher risk of developing eye melanoma.
• Ultraviolet (UV) radiation: The relationship between UV exposure and eye melanoma is uncertain. There is some evidence that exposure to UV radiation, whether from the sun or tanning beds, may increase the risk of melanoma in the eyes.
• Particular genetic changes: Eye melanoma may have a hereditary component passed down from parents.

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Diagnosis  Of Melanoma Of Eye

To diagnose ocular melanoma, your doctor may recommend:

• Eye analysis: Your doctor will check the outside of your eye, looking for any enlarged blood vessels that could indicate an inside tumor. After that, your doctor will inspect the interior of your eye with instruments.
• Slit lamp biomicroscopy: One method that places lenses and a strong light like a miner's lamp on your doctor's forehead is called binocular indirect ophthalmoscopy. Another method that uses lenses and a strong light beam from a microscope to highlight the inside of your eye is called slit-lamp biomicroscopy.
• Ocular ultrasonography: Using high-frequency sound waves from a portable, wand-like device called a transducer, an ocular ultrasound produces images of your eye. You can apply the transducer to your closed eyelid or the front surface of your eye.
• Angiograms are pictures of the blood vessels that surround and are inside of tumors: During an ocular angiography, a coloured dye is injected into a vein in the arm. The blood vessels in your eyes absorb the dye.Every few seconds for a few minutes, a camera fitted with specific filters to detect the dye takes a flash photo.
• Optical coherence tomography: Images of the retina and uveal tract are obtained during the imaging test.
• Biopsy: On rare occasions, your doctor may suggest undergoing a biopsy, which involves taking a sample of tissue from your eye.To remove the sample, a tiny needle is inserted into your eye to remove any suspicious tissue. Tests in a lab are conducted to determine whether the tissue contains eye melanoma cells. An eye biopsy is usually not necessary to diagnose eye melanoma.

Your doctor may suggest additional tests and treatments to determine whether the melanoma has spread (metastasized) to other parts of your body. Tests might include:

• Blood tests to assess liver function
• Chest X-ray 
• CT scan (computerized tomography)
• A magnetic resonance imaging (MRI) scan
• Positron emission tomography (PET) abdominal ultrasonography scan.

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Treatment  Of Melanoma Of Eye

Your treatment options will be influenced by the size and location of the ocular melanoma as well as your overall health and personal preferences.

A small ocular melanoma may not require immediate treatment. If the melanoma is small and not developing, you and your doctor may opt to wait and watch for any signs of growth.

If the melanoma progresses or becomes troublesome, you can then choose to pursue therapy.

Radiation therapy

Radiation therapy uses powerful energy, like protons or gamma rays, to kill cancer cells. Radiation therapy is typically used to treat small to medium-sized eye melanomas.

Radiation is applied to the tumor by placing a radioactive plaque right over it in your eye during a procedure called brachytherapy. The plaque is held in place using temporary sutures. The plaque, which resembles a bottle cap, contains many radioactive seeds. Four or five days after the plaque was placed, it was removed.

Furthermore, the radiation could come from an apparatus called external beam radiation, or teletherapy, which directs radiation, like proton beams, in the direction of your eye. 

Laser treatment

A procedure that uses a laser to kill the melanoma cells can be an option in some circumstances. Thermotherapy, a form of laser therapy that is sometimes coupled with radiation therapy, uses an infrared laser.

Photodynamic therapy

In photodynamic therapy, medications are mixed with a specific wavelength of light. Light can cause medication-induced harm to cancer cells. The treatment damages the arteries and cells that make up the melanoma in the eyes. Photodynamic therapy is used for minor tumors because it is not effective against more malignant ones.

Cold treatments

For some small-eye melanomas, cryotherapy—a very cold treatment—is a rare but useful treatment that includes killing melanoma cells.

Surgery

Treatment for eye melanoma involves a variety of procedures, including the removal of one or both eyes. The procedure you need will depend on the size and location of your ocular melanoma. Among the options are:

Surgery to remove the melanoma and a small amount of healthy tissue. Surgery to remove the melanoma and a strip of healthy tissue surrounding it may be necessary for the treatment of small melanomas.

Total ocular excision through surgery (enucleation). Enucleation is a common treatment for large eye tumors. It can also be utilized if the tumor is causing pain in the eyes.

After the melanoma-affected eye is removed, an implant is inserted in its original spot. Then, because the muscles controlling the movement of the eye are attached to the implant, it can move.

After you've had time to heal, a prosthetic eye is made. The front side of your new eye will be painted precisely to resemble the color of your original eye.

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Complications  Of Melanoma Of Eye

Complications from eye melanoma could include:

• Glaucoma, or increased intraocular pressure: Glaucoma may occur from an ocular melanoma that is still growing. Glaucoma symptoms might include redness and pain in the eyes in addition to impaired vision.
• Loss of vision: Large eye melanomas often result in vision loss in the affected eye, but they can also have repercussions like retinal detachment.There may be some vision loss if small eye melanomas form in key parts of the eye. It's conceivable that you're experiencing difficulties with side vision or central vision. Blindness could arise from an eye melanoma that has fully grown.
• Metastatic melanoma of the eyes: Melanoma in the eyes can metastasize to distant organs such as the liver, lungs, bones and beyond the eye.

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