Go to...
An ocular melanoma is a rare form of eye cancer. The medical term for this is uveal melanoma. This cancer usually begins in the layer behind the white of the eye, also known as the uvea. An ocular melanoma can occur in various parts of the eye, such as the choroid, the iris, or the ciliary body. It is most common in the choroid. Unlike skin melanoma, ocular melanoma has no clear link to sunlight.
In the Netherlands, approximately 220 people are diagnosed with ocular melanoma each year. Although most patients are between the ages of 50 and 70, it can also occur in younger people. The cause of ocular melanoma remains largely unknown.
Ocular melanoma is often detected when a person experiences symptoms, but these symptoms are common and not specific to ocular melanoma. The symptoms vary depending on the tumor’s location.
If you are diagnosed with eye cancer, it’s understandable that you have questions. Below, we explain how doctors make the diagnosis and what tests are involved.
1. Fundoscopy (eye examination):
– The ophthalmologist examines the retina at the back of your eye. This is done using an ophthalmoscope.
– By holding a magnifying lens up to your eye, the doctor can see the retina, the blood vessels, and any tumors.
– Eye drops will be administered beforehand to dilate your pupil. This may cause temporary blurred vision.
2. Ultrasound:
– The ophthalmologist uses sound waves to measure the thickness of the melanoma.
– The ophthalmologist examines your eye with a kind of flat probe while you look in different directions.
– The doctor can see the different tissues in your eye on a screen.
3. Fluorescein angiography (FAG):
– During this eye exam, the doctor takes pictures of the blood vessels in the retina.
– You will be injected with a dye, which spreads through the blood vessels.
– The dye makes any abnormalities in the retina visible.
After these tests, the doctor will tell you what type of ocular melanoma you have, where it is located, and how large it is.
If you are diagnosed with eye cancer, there are several treatment options available. You and your doctor will discuss which treatment is best for your situation. Below is an overview of the possible treatments:
For ocular melanoma, there are three possible forms of radiation therapy:
1. Ruthenium radiation therapy (brachytherapy): In this procedure, a radioactive source is placed close to the melanoma in the eye.
2. Stereotactic radiation therapy: This is a form of external radiation therapy that targets the melanoma.
3. Proton radiation therapy: In this procedure, protons are used to irradiate the melanoma from the outside.
Your doctor will discuss with you which type of radiation therapy is best suited to your situation, depending on the size, thickness, and location of the melanoma.
For a large ocular melanoma, surgery to remove the entire eye may be the best treatment. This procedure is performed to completely remove the tumor.
Sometimes you can choose between radiation therapy and surgery to remove the eye. Both treatments offer similar survival rates and quality of life. With radiation therapy, there is a chance that you will still be able to see (somewhat) with that eye, especially in the first few years after treatment. However, it is important to discuss with your doctor what matters most to you in life before making a decision.
In some cases, the doctor may suggest postponing treatment and monitoring the eye regularly. This happens, for example, if you have a very small ocular melanoma or if the melanoma is growing slowly. Your overall health often plays a role in this decision as well. If the melanoma becomes more active, you will still begin treatment.
Life can change dramatically after an eye melanoma. You’ll likely only be able to see out of one eye, and in some cases, you’ll receive an ocular prosthesis. You’ll face new challenges.
In some cases, ocular melanomas can spread. To predict whether an ocular melanoma will metastasize, doctors look at:
In cases of metastatic ocular melanoma, a cure is not possible. Treatment in such cases is aimed at slowing the progression of the disease, prolonging life, and alleviating symptoms.
On this website, you’ll find, among other things, tips for people who see with one eye, information about ocular prostheses and eye removal surgeries, and the emotional challenges you may face. Life after an ocular melanoma requires, above all, adaptation and patience. With the right information and support, you can continue to carry out your daily activities.
In our online library, you can readstories from others who have experienced eye cancer. You can also join our WhatsApp community and select the eye melanoma group.
Diagnosis, treatment, and follow-up care for ocular melanoma are provided at academic medical centers and a few larger hospitals. The leading ocular melanoma centers in the Netherlands are the LUMC in Leiden and the Erasmus MC in Rotterdam. Other hospitals in the Netherlands that treat ocular melanoma always do so in consultation with one of these two centers.
Henny had her eye removed after being diagnosed with ocular melanoma. “When my other eye bothers me, I sometimes get worried. After all, I only have one eye left to see with. Since my ocular melanoma, I often find myself wondering: what does the future hold? How will things turn out? Every six months, I have a chest X-ray and a liver ultrasound. It’s nerve-wracking every time. But when everything comes back normal, I just go on with my life for another six months.”
If you’re about to have an eye removed, you often have a lot of questions. What exactly is going to happen? What are the consequences of the surgery? Which doctor should I see?
There are glass and plastic ocular prostheses. What are the pros and cons of the different types? And where do you get these made?
What changes after an eye removal? How does that affect work or school, exercising, and driving, for example? How do you cope with fatigue and emotions?