Treatments for Ocular Melanoma

Dr. Russel Lazarus, November 18, 2021

Ocular melanoma is a rare form of eye cancer, affecting over 5 in a million people each year. 

What is ocular melanoma?

Ocular melanoma is a rare form of cancer that affects the eye. The most common type of ocular melanoma is called uveal melanoma, as it develops in the uvea, the part of the eye that contains the iris, ciliary body and choroid.

Ocular melanomas are diagnosed in up to 2,500 people every year in the US.

Most uveal tumors develop from the pigment cells, the melanocytes, within the uvea that give color to the eye.

When eye cancer metastasizes to other parts of the body, there is a 15 percent five-year survival rate. Fortunately, when caught early on, ocular melanoma can be treated.

What is the survival rate for ocular melanoma?

The overall 5-year survival rate for all eye-related melanoma is 82 percent.

When melanoma does not spread outside the eye, the 5-year relative survival rate increases to about 85 percent.

Unfortunately, the 5-year survival rate for those when the disease has spread to surrounding tissues or organs or the regional lymph nodes decreases to 71 percent.

Early detection of any cancerous or tumors of the eye is essential to achieving the best results.

SEE RELATED: Guide to Retinal Diseases

If you notice any changes to your eyes or vision, schedule an appointment with an eye doctor near you.

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How is ocular melanoma treated?

Ocular melanoma is frequently treated with radiation therapy, surgery or laser therapy. The most effective treatment plan will be dependent on the location, size and stage of the cancer, as well as the rate at which it is progressing.

1) Radiation therapy

Radiation therapy uses high-energy waves to eliminate cancer cells— and has been shown effective in preserving vision in those with ocular melanoma.

There are two different methods of radiation therapy:

1. External radiation therapy

Also known as ‘proton beam radiation’, this therapy involves targeting the tumor with radiation beams from outside the body.

This method reduces the risk of damage to the tissues surrounding the eye.

2. Internal radiation therapy

Also known as ‘radioactive plaque therapy’ or ’brachytherapy’, involves implanting radiation seeds in close proximity to the tumor inside the eye.

To protect the surrounding eye tissues, the radio-active seeds are encased in a metal plaque or disc.

2) Surgery

Eye cancer surgery involves removing the tumor and a portion of the surrounding healthy tissue.

Depending on the size, location and stage of the tumor, the surgeon will remove either the damaged sections of the eye, or the entire eye completely.

There are four different types of surgical procedures:

  1. Iridectomy involves removing part of the iris.
  2. Iridocyclectomy involves removing part of the iris and the ciliary body.
  3. Irido-trabeculectomy involves removing part of the iris and a small piece of the outer part of the eyeball.
  4. Enucleation involves removing the eyeball completely.

Removal of the entire eye may be necessary when other treatment methods are not effective in destroying the cancer cells.

When this occurs, an artificial eye, known as a prosthetic eye, is custom-fitted to match the size and color of the remaining eye.

3) Laser therapy

Laser therapy uses heat generating laser beams to shrink small tumors on the eye.

Laser therapy is generally only recommended in rare cases for the treatment of very small ocular melanomas or to reduce the risk of the cancer returning following radiation.

While half of all patients with ocular melanoma will recover and return to their normal activities with appropriate treatment, the other half may experience a recurrence at some point in the future.

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If you notice any changes to your eyes or vision, schedule an appointment with an eye doctor near you. 

While ocular melanoma is a rare form of cancer it is treatable. The sooner it is detected, the higher your chances for optimal treatment results.