What should you know about ocular melanoma?

Ocular melanoma is a melanoma of the eye that requires specialist examination, imaging and a personalised discussion of treatment. It may also be called uveal melanoma when it begins in the iris, ciliary body or choroid. The diagnosis is based on the eye findings and the overall clinical picture, not on a symptom alone.

A specialist examines the inside and outside of the eye and may use ultrasound or other imaging to map a suspicious lesion. Symptoms can include blurred vision, flashes, floaters, a dark mark or a missing area in the field of vision, but some lesions are detected incidentally. These symptoms also occur with other eye conditions, so they do not identify melanoma by themselves.

Important planning details include the tumour’s exact eye location, its relationship to vision-preserving structures, and the person’s general health. Follow-up may involve both eye checks and medical review, depending on the clinical assessment.

Keep the specialist appointments and ask for a plain-language explanation of each scan. Tell the team about changes in vision, prior eye disease and all medicines. Treatment may be observation for a selected lesion or active local treatment. Brachytherapy delivers radiation from a source positioned near the tumour, while radiotherapy can be planned to treat a defined target. The team weighs tumour control, eye preservation and possible effects on sight.

Get urgent help for sudden vision loss, a curtain or shadow across vision, abrupt flashes with a shower of floaters, severe eye pain, or an eye injury. During treatment or surveillance, report new or rapidly worsening blurred vision, pain, redness or discharge to the eye team. Prompt review can distinguish treatment effects from another eye emergency.

Ask which structure is affected, what the imaging shows, whether observation is reasonable, and what change would trigger treatment. Discuss the purpose and expected effects of brachytherapy or radiotherapy, how vision will be monitored, what follow-up schedule is planned, and whether another specialist should be involved in wider health checks.