Amelanotic choroidal melanoma: what patients should know

It develops from melanocytes in the choroid, the blood-rich layer beneath the retina. Unlike many melanomas, it may look pale rather than brown or black. An ophthalmologist uses an eye examination and imaging to distinguish it from other pale choroidal lesions.

The term amelanotic describes a lack of obvious pigment; it does not describe how mild or advanced the tumour is. Its position, thickness, associated fluid, eye findings and evidence of spread are more useful for planning care.

Some tumours are found during a routine dilated eye examination, while choroidal melanoma can also present with blurred vision, flashes, floaters, a shadow in the visual field or distortion. These symptoms have many possible causes, so examination is needed rather than self-diagnosis.

Arrange assessment by an ophthalmologist, ideally one experienced in eye tumours. Bring earlier eye photographs or scans if available and note when any visual change began. Evaluation may include a dilated examination, ultrasound and retinal imaging; the exact combination depends on what the specialist sees.

Treatment is individualised around tumour features, vision in both eyes and general health. Ask who will coordinate ocular treatment, wider staging and later surveillance. Do not delay an arranged review because the lesion is pale or because vision remains usable.

Seek urgent eye care for a sudden curtain-like shadow, abrupt loss of vision, a new shower of floaters, repeated flashes, or severe eye pain. These changes can signal retinal or other eye emergencies and warrant prompt assessment regardless of their cause.

Contact the treating team promptly for a new persistent visual change or worsening symptoms during follow-up. New severe headache, weakness, confusion or a seizure requires emergency assessment.

Ask what features support the diagnosis, whether comparison imaging would help, what the treatment aims to preserve, and how the plan could affect sight. You can also ask how the rest of the body will be assessed and which clinician to contact between appointments.