What should you know about melanoma behind the eye?

Melanoma can begin in pigment-producing cells inside the eye, including tissues that help you see. A person may notice blurred or reduced vision, flashes, floating spots, a shadow in the field of view, or a change in the appearance or position of the eye. Some people have no obvious symptoms and the finding is made during an eye examination.

These symptoms do not establish melanoma. Retinal problems, inflammation, bleeding, cataract or other eye conditions can look similar. If melanoma is confirmed, clinicians assess the eye and the rest of the body to understand the tumour and whether it has spread. Melanoma can spread to distant organs, including the brain, but a symptom alone cannot show that this has happened.

Arrange an urgent appointment with an ophthalmologist, especially when a visual change is new, persistent or affecting one eye. The assessment may include a detailed examination, pupil-dilated imaging and scans; the exact tests depend on what the specialist sees.

Take a list of medicines and prior cancer diagnoses, and record when the change began. Do not rub the eye or delay assessment while trying home treatments. If a tumour is suspected, your team may discuss observation, local treatment, surgery or systemic treatment according to its location, size and features.

Seek emergency care for sudden loss of vision, a curtain-like shadow, severe eye pain, marked redness, new double vision, weakness, confusion, trouble speaking or a seizure. These signs can reflect an eye emergency or a neurological problem and need immediate evaluation.

Ask where the lesion is located, which tests are needed, whether a biopsy is appropriate, how vision may be affected, and which treatments are realistic for your findings. Also ask how often follow-up examinations will occur and which symptoms should prompt a same-day call.