Intraocular (Uveal) Melanoma

Intraocular melanoma, also called uveal melanoma, is the most common primary cancer that develops inside the eye in adults. It begins in pigment-producing cells called melanocytes located within the uvea, the middle layer of the eye.

The uvea includes:

The choroid
The ciliary body
The iris

Most uveal melanomas develop in the choroid, which lies beneath the retina and helps supply blood and nutrients to the eye.

Although uveal melanoma is rare, it is a serious condition that requires prompt diagnosis and specialized treatment.

What Causes Uveal Melanoma?

The exact cause of uveal melanoma is not fully understood. The cancer develops when melanocytes inside the eye grow abnormally and form a tumor.

Several risk factors may increase the likelihood of developing uveal melanoma, including:

Fair skin or light-colored eyes
Older age
Certain inherited genetic conditions
Presence of a choroidal nevus (“eye freckle”)
Caucasian ethnicity

Unlike skin melanoma, the relationship between sunlight exposure and uveal melanoma is less clear.

Symptoms of Uveal Melanoma

Some patients have no symptoms, especially when tumors are small.

When symptoms occur, they may include:

Blurred vision
Flashes of light
Floaters
Loss of peripheral vision
Distorted vision
A dark spot in vision
Visible dark spot on the iris

In some cases, uveal melanoma is discovered during a routine dilated eye examination before symptoms develop.

Types of Uveal Melanoma

Choroidal Melanoma

This is the most common type and develops beneath the retina in the choroid.

Ciliary Body Melanoma

These tumors develop in the ciliary body, located behind the iris.

Iris Melanoma

Iris melanomas occur in the colored part of the eye and are often detected earlier because they may be visible during examination.

How Is Uveal Melanoma Diagnosed?

A retinal specialist or ocular oncologist diagnoses uveal melanoma through a detailed eye examination and specialized imaging tests.

Dilated Eye Examination

The tumor may appear as a raised pigmented mass inside the eye.

Ultrasound Imaging

Ultrasound is commonly used to measure the size and thickness of the tumor.

Optical Coherence Tomography (OCT)

OCT helps evaluate associated retinal swelling or fluid beneath the retina.

Fluorescein Angiography

This imaging test evaluates blood flow and leakage associated with the tumor.

Fundus Photography

Retinal photographs help document tumor appearance and monitor growth over time.

Can Uveal Melanoma Spread?

Yes. Uveal melanoma can spread (metastasize) to other parts of the body.

The liver is the most common site of metastasis, although the lungs and bones may also be affected.

The risk of spread depends on:

Tumor size
Tumor location
Genetic characteristics of the tumor
Whether the tumor is growing

Because of this risk, patients often undergo systemic monitoring with imaging and blood tests.

Treatment for Uveal Melanoma

Treatment depends on:

Tumor size
Tumor location
Vision potential
Overall health
Risk of spread

Plaque Radiation Therapy

Plaque brachytherapy is one of the most common treatments.

During this procedure:

A small radioactive plaque is sewn onto the outside of the eye
Radiation is delivered directly to the tumor
The plaque is removed several days later

This treatment can often preserve the eye and some vision.

Proton Beam Radiation

Highly focused proton radiation may be used in selected cases.

Laser Therapy

Laser treatment may occasionally be used for small tumors.

Surgery

Some tumors require surgical removal.

Enucleation

Large or advanced tumors may require removal of the eye (enucleation) to control the cancer and reduce pain.

What Is the Prognosis?

The prognosis depends on:

Tumor size
Tumor genetics
Whether the cancer has spread
How early treatment begins

Many patients are successfully treated before the cancer spreads. However, long-term monitoring is essential because metastasis can occur years later.

Patients typically require ongoing follow-up with both eye specialists and medical oncology teams.

Living With Uveal Melanoma

A diagnosis of eye cancer can feel overwhelming, but specialized treatment options are available.

Patients may benefit from:

Regular follow-up visits
Liver imaging and systemic monitoring
Low vision support if needed
Emotional support and counseling
Ocular oncology consultation

Early diagnosis and expert care are extremely important.

Frequently Asked Questions

Is uveal melanoma the same as skin melanoma?

No. Although both arise from pigment-producing cells called melanocytes, uveal melanoma is biologically different from skin melanoma and behaves differently.

Can uveal melanoma be cured?

Many tumors can be successfully treated when detected early. However, long-term monitoring is necessary because the cancer can spread to other organs.

Will treatment affect my vision?

Some treatments preserve useful vision, while others may cause partial or severe vision loss depending on tumor size and location.

More Information

For additional patient information, visit the American Society of Retina Specialists Intraocular (Uveal) Melanoma Page