Melanoma eye freckle: when a mark needs checking

People use freckle to describe several types of pigmentation. A flat mark on the iris may be longstanding and harmless, while a spot on the eyelid or facial skin may be a freckle, mole or another lesion. Features that deserve review include growth, new colour variation, an uneven outline, bleeding, crusting, itching, loss of nearby lashes or a mark that does not heal. A freckle itself does not diagnose melanoma.

An eye specialist can inspect the iris, pupil and inner eye structures. A dermatologist can assess nearby skin. Comparing a current photograph with earlier images can help show change, but it does not replace examination.

Book an appointment if a pigmented mark is new, changing or difficult to see clearly. Note its location and when you first noticed it; avoid picking at it or using cosmetic lightening products before review. Mention any history of melanoma, unusual moles or previous eye disease. The clinician may use magnification, photography and imaging, then decide whether monitoring or tissue testing is appropriate.

Arrange prompt assessment for a mark that enlarges, changes colour, bleeds, becomes sore, develops an irregular edge or causes loss of eyelashes. Seek urgent help for sudden vision loss, severe eye pain, a curtain-like shadow or new neurological symptoms. A stable mark can still be worth documenting if it has never been examined.

Is the pigmentation on the iris, eyelid or surrounding skin? Does it have features that need monitoring or testing? Can you photograph it for comparison? How often should it be reviewed? Which change should make me contact you sooner?