Melanoma eye cancer is an eye cancer that attacks cell melanocytes, which produce melanin. Melanin is the pigment that produces color in skin, hair, and eyes.
Melanoma eye cancer most often occurs in the uveal tissue, which includes the iris (rainbow membrane), ciliary body, and choroid.
Melanoma eye cancer that occurs in the uvea is also known as intraocular melanoma. This condition rarely causes specific symptoms in its early stages. In advanced stages, the growth of cancer cells can cause vision problems, the appearance of floaters, and even blindness.
Causes of Melanoma Eye Cancer
Melanoma eye cancer is caused by mutations or genetic changes in melanocyte cells. As a result, there will be uncontrolled cell growth, fast, and damage the cells and surrounding tissues.
The cause of this gene mutation is not known with certainty. However, there are several factors and conditions that can increase the risk of developing melanoma eye cancer, namely:
- Fair skin
- old age
- Have a light eye color, such as blue, green, or gray
- Frequent exposure to sunlight or ultraviolet light, including frequent use of ultraviolet lamps (sunbed) to darken the skin (tanning)
- Have certain skin conditions, such as dysplastic nevus syndrome, which is a condition when moles grow in large numbers and spread in various parts of the body
- Experience nevus of Ota or oculodermal melanocytosis, which is a condition in which there are excess melanocytes in the tissue resulting in hyperpigmentation (darker or brown spots appear) in the eye, including the uvea
In addition to some of the conditions previously mentioned, certain types of work can also increase the risk of developing melanoma eye cancer. An example is a welder. However, the relationship between the two still needs to be investigated further.
Symptoms of Melanoma Eye Cancer
Melanoma eye cancer can affect any part of the eye, including the conjunctiva (the outer layer of the eye). However, this condition most often affects the uvea of the eye which consists of the iris tissue, ciliary body, and choroid tissue.
Most melanoma eye cancers that grow in the uvea tend to be invisible, making it difficult to detect. Usually melanoma eye cancer, will only cause symptoms and complaints if it has developed at a more advanced stage.
Symptoms of melanoma eye cancer can vary in each patient. Generally this depends on the location and size of the cancer, as well as whether the growth of cancer cells has affected the retina. In general, some of the symptoms that indicate melanoma eye cancer are:
- Blurred vision, blurry vision, or loss of vision
- Loss of peripheral vision
- A black spot appears on the iris that looks bigger and bigger
- There is a sensation like seeing a flash of light
- Feels like there are spots or lines blocking the view
- Changes in pupil shape
When to go to the doctor
Do an examination to the doctor if the complaints and symptoms mentioned above appear. Symptoms of melanoma eye cancer can mimic those of other medical conditions. Early examination can determine the cause of the complaints you are experiencing.
Immediately see a doctor if you suddenly can not see. This can indicate a dangerous condition.
Melanoma Eye Cancer Diagnosis
Melanoma eye cancer often does not show any symptoms early in its development. This condition is usually detected during an eye examination for other complaints or ailments.
If you experience any of the symptoms mentioned above, check with your doctor to determine the cause. To determine the cause of the complaints you are experiencing, the doctor will ask questions about your complaints, medical history, and work history.
Next, the doctor will perform an examination to determine the condition of your eyes. During an eye exam, your doctor may put drops in your eye to enlarge the pupil. This is so that the doctor can see all parts of the eye.
After that, an eye examination will be carried out with the help of several tools, such as:
- Ophthalmoscopy, to view the inside of the eye, including the retina and optic nerve
- Slit lamp biomicroscopy, to examine the retina, optic nerve, and other parts of the eye using a beam and a microscope specifically used for the eye
- Gonioscopy, to see cancerous growths in areas that are difficult to see, this examination is also at the same time to see whether there is a blockage in the discharge of the eye fluid
If needed, the doctor will perform the following investigations to determine the condition of the eye and the spread of cancer, namely:
- Scans with eye ultrasound, CT scan, PET scan, and MRI, to see a picture of the condition inside the eye and to see the spread of eye cancer
- Eye angiography, to map the condition of the eye blood vessels, including knowing the presence of tumors
- Eye biopsy, to detect the presence of cancer cells by taking a sample of eye tissue
- Ocular coherence tomography (OCT), to determine eye conditions using light waves
According to its size, melanoma eye cancer can be divided into three categories, namely:
- Small, if the melanoma tissue is 5–16 mm wide and up to 1–3 mm thick
- Moderate, if the melanoma tissue is not more than 16 mm wide with a thickness of about 3.1–8 mm
- Large, if the melanoma tissue is more than 16 mm wide or more than 8 mm thick
Melanoma eye cancer can be classified as advanced cancer if it has spread to other tissues around the eye and the optic nerve. In addition to around the eyes, eye cancer can also spread to other parts of the body, such as the lymph nodes and liver.
Melanoma Eye Cancer Treatment
The type of treatment for melanoma eye cancer is determined based on the location, size, stage of the melanoma, as well as the patient's age and overall health condition. If the melanoma looks very small and does not spread, the doctor will make observations or observations by asking the patient for routine check-ups.
If the melanoma grows quickly, it will be treated. There are several methods of treating melanoma eye cancer that can be done, including:
Operation
Through this procedure, the doctor will remove the melanoma tissue in the eye. The operation performed depends on the size and symptoms of the cancer. If the cancer is small, surgery is performed to remove the cancerous tissue and a small amount of healthy tissue around the cancer. The operation is carried out by the method:
- Iridectomy, which is the removal of part of the iris
- Iridocyclectomy, which is the removal of the iris and ciliary body
- Sclerouvectomy or endoresection, which is the removal of the tumor by removing as little of the other eye as possible
Especially for large cancers, surgery is performed to remove the entire eyeball (enucleation). Usually, a prosthetic eyeball will be installed to improve the appearance of the eye.
Radiotherapy
Through radiotherapy, doctors will shoot high-energy radiation beams into cancer tissue. Radiotherapy is usually used to treat moderate-sized eye cancer. The types of radiotherapy that are usually used for melanoma eye cancer are: brachytherapy and stereotactic radiotherapy.
Cryotherapy
Cryotherapy is a method of treating eye cancer by freezing the cancer tissue so that it breaks down and dies.
Therapy radiation
This therapy uses light with a certain frequency. One example is thermotherapy which uses infrared light. Radiation therapy can also be combined with other therapies, especially radiotherapy.
Melanoma Eye Cancer Complications
If not treated properly, melanoma eye cancer can cause dangerous complications, such as:
- Glaucoma
- Cancer spreads to other parts of the body, such as the liver, bones, and lungs
- Retinal detachment
- Blindness
Melanoma Eye Cancer Prevention
The cause of melanoma eye cancer is still not known with certainty. Therefore, prevention that can be done is to avoid factors that can increase the risk of this condition. Some things that can be done are:
- Avoid excessive exposure to ultraviolet light, for example by wearing protective glasses when doing therapy with ultraviolet lamps (sunbed) or wearing sunglasses when working in the hot sun.
- Wear eye protection when performing activities that could injure or harm the eyes.