Choroidal Melanoma: Diagnosis and Treatment

Written by Medicover Team and Medically Reviewed by Dr Neelesh Kanderi , Oncologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Choroidal melanoma is the most common primary cancer that develops inside the eye in adults, arising from the pigment-producing cells of the choroid. Although it is a rare condition, it can grow silently and may spread to other organs, particularly the liver, if left untreated. Common symptoms include blurred vision, flashes of light, floaters, visual field loss, or it may be detected during a routine eye examination before symptoms develop.

Diagnosis is confirmed through a comprehensive eye examination, ocular ultrasound, optical coherence tomography (OCT), fluorescein angiography, and other imaging studies. Treatment depends on the size and location of the tumor and may include radiation therapy, laser treatment, surgery, or, in advanced cases, removal of the affected eye to prevent the spread of cancer.

What are the Symptoms of Choroidal Melanoma?

The symptoms of choroidal melanoma can vary depending on the size and location of the tumor. In its early stages, it may not cause any noticeable symptoms and is often detected during a routine eye examination. As the tumor grows, symptoms may include:

Visual Disturbances: Blurred vision, loss of peripheral vision, or flashes of light are common symptoms.
Floaters: Small dark spots or lines that drift across the field of vision.
Changes in Eye Appearance: The affected eye may appear darker or show visible changes in appearance.
Eye Pain or Discomfort: Although uncommon, some individuals may experience pain or discomfort in the affected eye.

Early detection through regular eye examinations is essential for improving treatment outcomes.

What are the Causes of Choroidal Melanoma?

The exact cause of choroidal melanoma is not fully understood, but several factors may increase the risk of developing this eye cancer.

Genetic Predisposition: Certain inherited or acquired genetic mutations may increase the risk of choroidal melanoma.
Exposure to Ultraviolet (UV) Light: Long-term exposure to ultraviolet radiation may contribute to the development of melanoma.
Fair Skin and Light-Colored Eyes: Individuals with fair skin and blue, green, or gray eyes have a higher risk.
Age and Gender: Choroidal melanoma is more commonly diagnosed in older adults and occurs slightly more often in men.

When to See a Doctor for Choroidal Melanoma?

If you develop symptoms suggestive of choroidal melanoma, consult an Oncologist promptly. Early diagnosis and treatment can help preserve vision, prevent the spread of cancer, and improve long-term outcomes.

If you experience persistent blurred vision, reduced vision, or sudden changes in your eyesight.
If you notice flashes of light, new floaters, or loss of peripheral vision.
If you develop a dark spot or shadow in your field of vision.
If you experience eye pain, redness, or pressure that does not improve.
If a routine eye examination detects a suspicious pigmented lesion or tumor inside the eye.
If you have a family history of ocular melanoma or other melanoma-related cancers and develop new eye symptoms.
If imaging studies reveal an abnormal growth in the choroid requiring further evaluation.
If your symptoms persist or worsen, consult an Oncologist promptly for a comprehensive evaluation, diagnostic imaging, staging, and appropriate treatment.

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How is Choroidal Melanoma Diagnosed?

Diagnosing choroidal melanoma involves a comprehensive eye examination along with specialized imaging tests to determine the size, location, and characteristics of the tumor.

Ophthalmoscopy: A detailed examination of the inside of the eye using specialized instruments.
Ocular Ultrasound: Helps evaluate the size, shape, and location of the tumor.
Fluorescein Angiography: Uses a special dye to visualize blood vessels and identify abnormal blood flow within the eye.
Optical Coherence Tomography (OCT): Produces detailed cross-sectional images of the retina and choroid.

In selected cases, a biopsy may be performed to confirm the diagnosis and analyze the tumor's genetic profile, which may help guide treatment decisions.

What are the Treatment Options for Choroidal Melanoma?

Treatment depends on the size, location, and extent of the tumor, as well as the patient's overall health and vision.

Radiation Therapy

Radiation therapy is one of the most common treatments. Plaque brachytherapy involves placing a small radioactive plaque over the tumor to deliver targeted radiation while minimizing damage to surrounding healthy tissue.

Laser Treatment

Laser therapy, including transpupillary thermotherapy (TTT), uses infrared laser energy to destroy cancer cells. It is generally used for smaller tumors or in combination with radiation therapy.

Surgical Options

Surgical treatment may involve local tumor removal or enucleation (removal of the eye) for large tumors or when vision cannot be preserved.

Experimental Treatments

Emerging therapies, including targeted therapy and immunotherapy, are currently being studied to improve outcomes in patients with advanced or metastatic choroidal melanoma.

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What is the Prognosis of Choroidal Melanoma?

The prognosis of choroidal melanoma depends on the size, location, genetic characteristics, and whether the cancer has spread beyond the eye. Smaller tumors detected early generally have a better prognosis than larger or metastatic tumors. Regular follow-up is essential because choroidal melanoma most commonly spreads to the liver, and ongoing monitoring helps detect recurrence or metastasis at an early stage.

Frequently Asked Questions

1. What are the symptoms of choroidal melanoma?

Symptoms may include vision changes, a visible dark spot in the eye, or blurred vision, often leading to the discovery of the tumor during an eye exam.