Uveal melanoma, or ocular melanoma, is a cancer that happens inside your eyeball. It’s rare. Just 7 out of every 1 million people get it each year. But it’s also the most common eye cancer for adults. Sometimes the disease can spread, or metastasize, to other parts of your body. But how do you know if you have it? And what happens if it spreads? Here’s what to know about uveal melanoma, its causes, its symptoms, and potential complications.
What Is Metastatic Uveal Melanoma?
A melanoma is a cancer that begins in the cells that make your skin, hair, and eyes colorful by producing pigments. When this type of cancer happens in a certain part of your eye – the uvea – it’s called uveal melanoma. The uvea, one layer of your eye’s walls, includes three parts:
- Iris, the colored ring around your pupil that’s visible on the front of your eye
- Ciliary body, a muscle beyond your iris that helps your eye’s lens change shape when it focuses. It also produces the clear liquid (aqueous humor) that fills in the gap between your iris and cornea
- Choroid layer, tissue between the white outer layer of the eye and the retina that has blood vessels that bring oxygen and nutrients to the eye
Depending on which part of the uvea is affected, your cancer can be more likely or less likely to spread. Metastatic uveal melanoma is more likely when your original tumor was in your choroid (the most common site) or ciliary body, rather than in your iris.
What Makes It ‘Metastatic’?
Metastatic is a word that refers to when a cancer grows outside of the place where it starts. So, having metastatic uveal melanoma simply means that your disease is no longer located only in your eye. For about half of the people diagnosed and treated for uveal melanoma, it will eventually spread within the next 15 years. Most often – 90% of the time – it spreads to the liver. But it also can end up in the lungs, bones, or brain.
The good news is there are treatments that, especially when started early, can help you live longer and improve your quality of life. So, if you have reasons to suspect your cancer may have returned or spread, don’t put off speaking with your doctor. They can help you figure out next steps.
Who’s Most at Risk and Why?
The exact cause of uveal melanoma isn’t known, though some things may put you at higher risk:
- Older age; most often it’s diagnosed between ages 55 and 60
- Light eye color, most frequently seen in people whose eyes are blue, grey, or green
- Pale skin
- Inherited skin disorders such as dysplastic nevus syndrome (which causes unusual-looking moles) and ocular melanocytosis (which causes the eyelids, uvea, and nearby areas to have an unusual color)
- Other genetic mutations passed on to you from your parent, such as those affecting the BAP1 gene, that can put you at higher risk of not only uveal melanoma but also skin melanoma and other cancers
Exposure to ultraviolet light, such as from the sun or tanning beds, may also increase the odds of uveal melanoma. But, it’s not yet clear if this is the case.
What Are the Main Symptoms of Metastatic Uveal Melanoma?
You may be concerned you or a loved one has uveal melanoma. Early in the disease, it’s possible you might not have any symptoms. Your ophthalmologist or optometrist (eye doctor) may instead find the cancer during your exam, when they dilate your pupil to see what’s going on inside your eye. Later on, as the disease gets worse, there can be noticeable symptoms, such as:
- Flashes of light in your vision
- Floaters, where spots or “dust” drift into your field of vision
- Changes in your pupil, either its size or shape
- Changes in how your eyeball fits into your eye socket
- Blurriness, poor vision, worsening peripheral vision (you can see straight ahead but not on the sides), or other changes in how well you see with one of your eyes
If you’re worried you may have this cancer, know that many of these symptoms also can be signs of other eye conditions. Talk with your primary care doctor about what to do. They’ll likely refer you to a specialist who can figure out what’s causing your eye problems. It’s important to speak up, because cancers are best addressed when they’re found early. Sudden changes can be signs of emergency, so if you have them, act quickly.
What Problems Can Uveal Melanoma Cause?
Uveal melanoma can cause complications, even when it hasn’t spread elsewhere in your body. Among them are:
- Glaucoma, or increasing pressure inside your eye. Symptoms include eye pain, eye redness, and blurry vision.
- Retinal detachment, when the layer of tissue at the back of the eye pulls away from its normal place and separates from blood vessels
- Partial vision loss, which can happen even with small cancers
- Complete vision loss, which can come with advanced cases
Photo Credit: SEBASTIAN KAULITZKI / SCIENCE PHOTO LIBRARY / Getty Images
Columbia University Department of Ophthalmology: “Uveal Melanoma.”
Moorfields Eye Hospital, NHS Foundation Trust: “Uveal Melanoma.”
National Cancer Institute: “Ciliary Body,” “Choroid.”
Mayo Clinic: “Eye melanoma,” “Retinal detachment.”
Cancer Research UK: “Risks and causes of eye cancer.”
Skin Cancer Foundation: “Atypical Moles & Your Skin.”