What should you know about scleral melanoma?

The sclera is the firm white layer around most of the eye. A dark patch, raised area, or colour change there may have several explanations, including a benign pigmented lesion, inflammation, or a tumour. Scleral melanoma can be difficult to identify by appearance alone. An eye specialist may examine the surface and inside of the eye, photograph the finding, and use imaging to understand its depth and extent. Melanoma can spread beyond its original site, so assessment may also consider nearby lymph nodes and other organs.

Arrange an appointment with an ophthalmologist or ocular oncology service if you notice a new or changing dark mark, a lump, unexplained irritation, or a change in vision. Do not scrape, burn, or try to remove the area yourself. Take a clear photograph only to help show change over time, and bring a list of medicines and previous eye diagnoses. Depending on the examination, care may include observation, a biopsy, local treatment, or surgery. If melanoma is confirmed, the team will explain whether staging tests, sentinel lymph node biopsy, tumour removal surgery, or immunotherapy are relevant.

Seek urgent medical attention for sudden or worsening vision loss, severe eye pain, marked redness, bleeding, a rapidly enlarging lesion, or new flashes and floaters with a curtain-like shadow. These symptoms do not prove melanoma, but they can signal an eye emergency. Prompt review is also appropriate for a persistent colour change or lump, even when it is painless.

Ask where the lesion is located, what tests are needed, whether a biopsy is safe, how the diagnosis would affect vision, and which warning signs should trigger an earlier review. You can also ask how follow-up will monitor recurrence or spread.