Have you ever heard that cancer can develop inside the eye? Maybe you've noticed a slight change in your vision, or something like a black spot inside your eye. Today we're going to talk about a cancer that can be related to something like that, but is very rare, that is, very rarely seen. This is called Intraocular Melanoma . Don't worry, let's explain everything about this simply.
What is this intraocular melanoma?
Simply put, Intraocular Melanoma is a cancer that develops inside our eyes. There is a type of cell that gives color to our eyes, called melanocytes . This cancer develops when these cells start to grow uncontrollably and excessively. This can sometimes cause vision changes, vision loss, or even complete loss of vision .
Where in the eye does this occur? (Learn about the Uvea)
Intraocular Melanoma usually develops in the middle layer of the eye. This is called the uvea . Imagine that the eye is like a small ball. The white part on the outside is called the sclera . The part inside the eye that detects light and controls vision is the retina . In between those two is the uvea .
The uvea has three main parts:
- Iris: This is the part of the eye that gives it its color, the blue and brown color you've seen in some people.
- Ciliary body: This is a ring of muscle behind the iris. It helps control the lens inside the eye.
- Choroid: This is the membrane that contains many blood vessels that supply the eye with oxygen and nutrients.
Most often, melanoma starts in the choroid . Sometimes, this cancer can spread (metastasize) from the inside of the eye to other parts of the body. The most common site of spread is the liver .
It is important to note that intraocular melanoma and skin melanoma are two different conditions. Although the cell type is the same, these are two different diseases.
Can this really cause vision loss?
Yes, some people with intraocular melanoma can have vision problems. The extent of vision loss depends on the size of the tumor and how long it has been in the eye. Sometimes, melanoma that has been present for a long time can cause complete vision loss. That's why it's important to recognize it early.
Who is most likely to develop this disease? (Risk factors)
There are certain risk factors that can affect the development of melanoma in the eye. This means that people with these things are slightly more likely to develop the disease than others.
- For those with very fair skin: That is, those with light skin, eye, and hair color.
- Light-colored eyes or light-colored skin.
- Being between 70 and 80 years old: This risk increases slightly as you get older.
- If someone in your family has had Uveal Melanoma before: However, this is very rare.
How common is this really?
Intraocular melanoma is the most common type of cancer that develops inside the eye in adults, but overall it is a very rare cancer . For example, in a country like the United States, only about 2,500 new cases of the disease are diagnosed each year. This means that it is not a disease that affects everyone.
Why does melanoma develop inside the eye? (Causes)
Our genes tell the cells in our body how to divide and how to function. These genes are made up of DNA . Imagine, if there is a mutation , that is, a change, in this gene, it can send wrong instructions to the cells. That is when the cells divide uncontrollably, leading to cancer.
Something similar happens in melanoma inside the eye. The melanocytes, which we talked about earlier, inside the eye, receive incorrect instructions from their genes. Then those cells multiply excessively and form cancerous tumors .
What are the symptoms of this? (Things to be concerned about)
Sometimes, even if you have intraocular melanoma, it may not show any symptoms . Or, because the cancer is inside the eye, where we can't see it from the outside, it can be difficult to recognize the symptoms.
However, when symptoms appear, you may see things like:
- Blind spots or a reduced field of vision: It's like you can't see certain areas when you look.
- Blurred or low vision.
- Changes in the position of the eye: the eye appears to be sunken or protruding.
- Changes in the size or shape of the black spot in the middle of the eye (pupil).
- A dark spot on the iris.
- Displacement of the lens inside the eye: This can happen especially if there is melanoma in the ciliary body .
- Double vision.
- Eye pain.
- Floaters or flashes of light. Imagine, sometimes you suddenly see a black dot or something like a ball of thread floating in front of your eyes, right? Like that.
- Retinal detachment: This can occur, especially if there is melanoma in the choroid .
How does a doctor diagnose this? (Diagnosis)
If you have these symptoms, your doctor will first ask you about your condition and take a medical history. Then they will perform an eye exam . This will check your vision and use special instruments to look inside your eye. Sometimes, special eye drops may be used to enlarge the pupil in the middle of your eye. This will allow the doctor to see the structures behind your eye more clearly.
Some other tests can also be done:
- Angiography: This checks for blockages or leaks in the blood vessels in the choroid .
- Ultrasound: This can measure the size of the structures inside the eye and check for tumors. It's similar to a scan that looks at a baby in the womb.
If your doctor diagnoses this as intraocular melanoma, they may order additional imaging tests or blood tests. These are used to determine the stage of the cancer. That is, to find out if the cancer has spread outside the eye to other parts of the body.
What are the treatments for this?
If you have no symptoms from a tumor inside your eye, your vision is not affected, and the tumor is small (less than 2.5 millimeters thick), you may not need to start treatment right away . Your doctor may recommend something called " watchful waiting ." This means waiting a while before starting treatment, while constantly monitoring the tumor to see if it grows.
However, if you need treatment, the most common treatments are radiation therapy or surgery . The treatment that is right for you will depend on factors such as:
- Where the tumor is.
- The size and thickness of the tumor.
- Whether the cancer has spread to other parts of the body.
- Your age and general health.
How is surgery performed?
There are several types of surgery for intraocular melanoma:
- External resection: In this, the cancerous tumor and a small amount of healthy tissue around it are cut out from the outside of the eye inwards.
- Enucleation: This involves removing the eye and part of the optic nerve.
All of these surgeries carry some risk of vision loss. Although a prosthetic eye can be inserted after enucleation, the eye will not provide vision.
What are the methods of radiation therapy?
Radiation therapy is a method of destroying cancerous tumors using high doses of radiation. Depending on the size and location of your tumor, your doctor may suggest the following:
- External radiation therapy: In this, radiation beams are directed at the tumor from outside the body. Special techniques, such as proton beam radiation, can target the tumor precisely, minimizing damage to surrounding eye and brain tissue.
- Internal radiation therapy: This involves placing radioactive "seeds" inside the eye, near the tumor. Doctors call this method radioactive plaque therapy . These "seeds" are inside a metal disk (Plaque/Disk). This prevents radiation from damaging other parts of the eye.
What other treatments are available?
There are several other treatment methods:
- Transpupillary thermal therapy (TTT): This uses heat from laser beams to destroy the tumor.
- Endoresection: This involves surgically removing the tumor from inside the eye.
What are the chances of recovery if you develop this disease? (Outlook)
Research shows that between 40% and 50% of people with intraocular melanoma will spread to other parts of the body. Of those cases, about 90% will spread to the liver . Melanomas that develop in the choroid and ciliary body are more likely to spread than melanomas that develop in the iris .
But remember, like all cancers, the sooner this is identified and treatment begins, the greater the chance of a cure.
Can we prevent this from happening?
In fact, we cannot control many of the risk factors for developing intraocular melanoma, such as age and skin color. However, the most important thing you can do is to regularly see an ophthalmologist and have your eyes checked. That way, if there is a problem, it can be identified early.
What should I do if I have this condition?
If your doctor tells you that you have this condition, the most important thing is to stay in touch with him/her and monitor the condition closely. You may also need to have liver imaging exams from time to time to see if the cancer has spread. Don't worry, your doctor will give you all the advice you need.
What should I ask the doctor?
If you have intraocular melanoma, you may want to ask your doctor questions like:
- How big is the fruit?
- What treatments are suitable for me?
- Will the treatment affect my vision?
- Are there any clinical trials I can participate in?
- Can cancer come back after treatment?
Take-Home Message
Intraocular Melanoma is a type of cancer that affects the cells inside the eye, especially the uvea . Symptoms can include vision loss and changes in the appearance of the eye. It can also spread to other parts of the body, such as the liver. Radiation therapy and surgery are the main treatments. Although this is a very rare condition, early detection and proper treatment are very important. Therefore, take care of your eyes and don't forget to have regular eye exams.
` Intraocular Melanoma, Eye Cancer, Uveal Melanoma, Eye Cancer Symptoms, Eye Cancer Treatment, Vision Loss
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