Informational only — Not medical advice. Always consult a licensed healthcare provider.
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⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
Eye cancer is rare. About 850 people are diagnosed with it in the UK each year.
Several different cancers can affect the eye, and eye melanoma is the most common. You may also hear it called ocular melanoma.
Melanoma is a cancer that starts from cells called melanocytes. These cells give skin its colour, and melanoma usually develops in the skin. But melanocytes are found in other parts of the body too, so melanoma can start in places like the eye.
This information is about eye melanoma.
Your eye is made up of different layers of tissue and is filled with a clear jelly. All its parts work together to help you see.
The conjunctiva is a thin, clear lining. It covers and protects the white outer surface of the eye and the inside of the eyelids.
Around the eyeball, the middle layer is called the uvea. It controls how light comes into the eyeball and helps the eye to focus. It also makes a fluid around the lens (the clear inner part of the eye), and this fluid keeps your eye healthy.
There are 2 main types of eye melanoma:
Eye melanoma doesn't always cause symptoms. Sometimes an optician finds it during a routine eye test.
Uveal melanoma symptoms may include:
Conjunctival melanoma symptoms may include:
Other eye conditions can cause these symptoms too. But if you notice any of them, or any other change in your eyes, tell your doctor or optician straight away.
Doctors don't know what causes eye melanoma. There are, though, some risk factors that can raise the chance of developing it.
Uveal melanoma, a type of eye cancer, is more common in people with:
It's rare in people with brown eyes, or if you're Black or Asian.
Exposure to ultraviolet rays (UV rays) is the main risk factor for skin melanoma. Whether it also raises the risk of uveal melanoma, a type of eye cancer, isn't clear.
For conjunctival melanoma, there is some evidence of a link with UV ray exposure through sunlight, sunbeds or sunlamps.
Eye melanoma is more common in people who have atypical mole syndrome. If you have this condition, you usually have more than 100 moles on your body.
Conjunctival melanoma usually develops from a rare condition called primary acquired melanosis (PAM). In PAM, many brown or dark patches (pigmentation) appear on the conjunctiva, usually in one eye.
PAM can be monitored, so any signs of it changing are found early and treated.
Sometimes the melanoma develops suddenly. But it can also grow from a freckle or mole that is already on the conjunctiva.
With symptoms of eye cancer, you'll usually start by seeing your optician or doctor. Should they be unsure what the problem is, they'll refer you to a specialist eye doctor at the hospital. This doctor is called an ophthalmologist.
When the ophthalmologist thinks you have eye melanoma, they'll refer you to a national eye cancer centre straight away. These are based in eye hospitals or in a general hospital, depending on where you live.
At the hospital, a doctor will examine your eye using a small handheld lens and light. This is called an ophthalmoscope. Or they may ask you to look into a large microscope that sits on a table.
Eye tests can include taking photographs, scans and ultrasounds of the eye. You may have a test called an eye angiogram to check the blood vessels at the back of the eye (retina).
It's rare to need a biopsy to diagnose eye cancer. But it may be done in some situations.
Macmillan Cancer Support, a UK charity, has more detailed information about:
Your test results tell the doctors more about how big the cancer is, where it sits and whether it has spread. This is called staging. Once the doctors know the stage, they can plan the best treatment for you.
Doctors commonly use the TNM staging system for eye melanoma. TNM stands for tumour, nodes, metastases.
T describes the size of the tumour and whether it has grown into other parts of the eye (intraocular) or into areas outside the eyeball (extraocular). It also measures how thick and how wide the eye melanoma is.
N tells you whether the cancer has spread to lymph nodes near the eye. N0 means there are no cancer cells in the nearby lymph nodes. N1 means there are cancer cells in the lymph nodes. Conjunctival melanoma is more likely to spread to nearby lymph nodes.
M tells you whether the cancer has spread to another part of the body. This is called metastatic cancer. M0 means the cancer has not spread. M1 means it has spread to other organs, like the liver.
Your doctor or nurse may describe the tumour as small, medium or large. Or they may describe it as:
A team of specialists will meet to discuss and plan the best treatment for your eye cancer. This team is called a multidisciplinary team (MDT).
Your cancer doctor and nurse will explain the different treatments and their side effects. They'll also talk with you about what to think over before you decide. After that, you and your doctor can choose the best treatment for you.
The aim of treatment is to destroy the cancer cells while doing as little damage as possible to your eyesight. Uveal and conjunctival melanomas are treated in different ways.
Your treatment plan will depend on:
The most common treatment for uveal melanoma is radiotherapy, and it's usually very effective. Surgery is more commonly used to treat conjunctival melanoma. You may have a combination of treatments.
If the eye melanoma has spread to other parts of the body, you may have treatment with immunotherapy and targeted drugs. Sometimes a small area of spread can be removed with surgery.
Treatment for eye cancer may include the following.
Radiotherapy for eye cancer uses high-energy rays to destroy the cancer cells, while harming normal cells as little as possible. The most common way to give it is to place a small radioactive disc on the outside of the eye. This is called brachytherapy.
Radiotherapy can also come from a machine outside the body, which is called external radiotherapy. It includes specialised techniques such as stereotactic radiation therapy and proton beam radiotherapy.
Side effects can appear during treatment and for a few weeks after it. Some may last longer. Your doctor and nurse will explain the side effects to you.
Not every eye cancer needs surgery. For conjunctival melanoma, though, it's the most common treatment.
The surgeon removes the tumour from the surface of the eye, along with a small amount of healthy conjunctiva around it. This is called local resection.
With uveal melanoma, you will rarely have surgery.
Sometimes doctors advise removing the whole eye. They do this only when they are certain it's the best treatment for you. It may be done if the tumour is too large to be treated with radiotherapy, or if the eye becomes painful after radiotherapy.
Your doctor may suggest cryotherapy to lower the risk of conjunctival melanoma coming back. In this treatment, the doctor freezes the area to kill any cancer cells that may still be there after surgery.
You may be given a local or a general anaesthetic for the treatment.
Your doctor may suggest chemotherapy or immunotherapy eye drops if you have conjunctival melanoma. You might have them before surgery, or after it. Your doctor or a specialist nurse will show you how to use the drops.
The drops can make your eye and eyelid red and sore. If this happens, tell your doctor or nurse.
Doctors may use photodynamic therapy (PDT) to treat small uveal melanomas. It works by combining a light-sensitive drug with a laser or another light source, and together they destroy the melanoma cells.
The treatment is painless and takes only a few minutes. But your eyes and skin will be sensitive to light for several days afterwards.
You may have up to 3 PDT treatments, with 1 month between each one.
When your eye cancer treatment ends, your doctors and nurses will talk to you about what to expect. They'll also tell you about any follow-up care you may need. You may still have side effects from the treatment, and other emotions to cope with. It takes time to recover.
For some people, treatment for eye cancer changes their appearance, and this can affect their body image. If you have changes that are hard to adjust to, talk to your nurse or doctor. They may be able to refer you for specialised support.
Cancer and its treatment can also affect your sex life.
After treatment for eye melanoma, you'll have regular appointments with your specialist eye doctor and nurse. They'll tell you how often to come.
At each appointment, they'll check your eye and the area around it. Your doctor will also ask whether the treatment is causing any side effects.
You may have scans or X-rays to check the eye. Some people have regular blood tests and scans to check their liver and other organs.
If you have any problems or notice new symptoms anywhere in your body, contact your specialist doctor or nurse straight away. Don't wait until your next appointment.
Once your treatment for eye cancer is over, you may want to make some positive changes to how you live, even if your lifestyle is already healthy. Small things, like eating well and keeping active, can improve your health and wellbeing, and they help your body recover.
