What should you know about end stage ocular melanoma?

Ocular melanoma begins in the eye and may affect vision, eye comfort, or the tissues around the eye. In advanced disease, clinicians also assess whether melanoma has spread elsewhere, which can change the treatment plan. Symptoms can include blurred or reduced vision, flashes, new floaters, a changing visual field, eye pain, or a visible change in the eye, although symptoms do not always reflect the full extent of disease. Your specialist may use eye examinations and body imaging to guide decisions. The experience and outlook are different for each person.

Ask the ocular oncology team to explain the aims of each option: controlling melanoma, preserving useful vision, easing pain, or supporting comfort. Brachytherapy is a form of focused radiation that may be used for selected tumours within the eye; radiotherapy may be considered for other sites or symptoms. If vision is changing, ask about low-vision services, lighting, mobility support, and help with medicines or meals. Palliative care can be involved when symptoms or emotional strain need extra attention.

Seek urgent assessment for sudden loss of vision, severe eye pain, a new curtain-like shadow, marked redness with nausea, a seizure, new weakness, confusion, or severe breathlessness. Contact the treating team promptly for new flashes, a rapid increase in floaters, persistent vomiting, or pain that is not controlled by the agreed plan.

Where is the melanoma now, and what tests are needed? Is the aim to preserve vision, control spread, relieve symptoms, or combine these goals? What side effects should we watch for? Who should we call urgently? Could low-vision or palliative support help at home?