Diagnosing ocular melanoma

Many tumours inside the eye have a characteristic appearance on examination and ultrasound, so treatment planning may proceed without taking tissue first. The specialist also evaluates tumour size and location, its relationship to structures needed for vision, and whether assessment elsewhere in the body is indicated.

The visit may include dilating drops so the clinician can inspect the retina, choroid and optic nerve. Eye ultrasound can measure a lesion and show its internal features. Retinal photography and specialised scans document the surface, blood flow, fluid and changes in nearby retinal layers for comparison over time.

A biopsy may be discussed when the appearance is uncertain or tumour cells are needed for additional analysis, but sampling has limitations and potential risks. Separate scans or blood tests may be arranged to check general health and look beyond the eye. A pigmented spot or visual symptom alone cannot determine whether melanoma is present.

Bring previous eye photographs, scan reports, glasses information, a medicine list and details of earlier eye disease or surgery. Describe when flashes, floaters, blurred vision, a missing part of the visual field or a visible eye change began. Some ocular melanomas cause no noticeable symptoms and are found during a routine examination.

Dilating drops can blur near vision and increase light sensitivity for several hours, so arrange transport if the clinic advises against driving. Ask which tests are planned, whether they involve dye or contrast, and whether kidney problems, allergies, pregnancy or breastfeeding change the preparation. Keep follow-up imaging appointments so the team can compare the lesion accurately.

Sudden vision loss, a dark curtain across vision, a rapid shower of new floaters, flashing lights with a new visual-field gap, or severe eye pain needs urgent eye assessment. These symptoms can come from several eye emergencies and should not wait for a routine cancer appointment. Contact the treating service promptly for worsening vision or new symptoms after an eye procedure.

Ask which part of the eye contains the lesion, what features support the diagnosis, and whether comparison with earlier images is possible. Clarify whether a biopsy would alter management, which examinations assess spread, and how the proposed treatment may affect central or peripheral vision. Also ask who coordinates eye care and oncology follow-up.