What Is Melanoma Eye Cancer?

Melanoma eye cancer is a cancer that occurs in eye melanocyte cells that function to produce melanin. Melanin is a pigment that produces color on the skin, hair and eyes. Therefore melanoma can also occur in the skin.

Melanoma in the eye generally grows in the eye uvea tissue, which includes the iris tissue of the eye, the ciliary body, and the choroid tissue. Often melanoma eye cancer occurs in the eyes that are not visible when looking in the mirror. In addition, these cancers rarely cause specific symptoms in the early stages. Both cause melanoma eye cancer is difficult to detect at an early stage, and is usually found accidentally during routine eye examination. But as the cancer tissue grows, it will cause shape changes in pupils, blurred vision, and decreased vision ability.

Melanoma eye cancer can be treated well especially if it is still in its early stages and is small. Treatment of small cancers rarely impairs the patient's vision ability. Conversely, if the cancer is already large, the treatment provided can cause interference with the patient's vision.

Symptoms of Melanoma Eye Cancer
Most of the melanoma in the eye grows on the inside of the eye that tends to be invisible, making it difficult to detect. These cancers also rarely cause significant symptoms. If there are indications that appear, usually in the form:

• Black spots appear on the irises of the eye.
• The sense of seeing a flash of light.
• Feeling there are spots or lines that block the view.
• Blurred vision or loss of vision.
• Changes in pupil shape.
• Swelling of one eye.
• Lumps on the petals or eyeballs that grow larger.

Although these symptoms can also appear not because of eye cancer melanoma, but if you experience these symptoms, it is recommended to immediately consult a specialist eye.

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Causes and Risk Factors of Melanoma Eye Cancer
Melanoma eye cancer is caused by changes or DNA mutations in eye melanocyte cells resulting in uncontrolled cell growth. This uncontrolled growth melanoma tissue will cause damage to healthy eye tissue.

Melanoma can occur in various parts of the eye, either on the front of the eye such as irises and ciliary bodies, or on the back or precisely in the choroid tissue. But in rare cases, melanoma cancer can grow at the very front of the eye, namely in the conjunctiva.

Genetic mutations in eye cells are unclear, but there are some things that can lead to the mutation, among them:

• Fair skin.
• Sun exposure and ultraviolet, including frequent use of ultraviolet light (sunbed) to darken the skin (tanning).
• Age factor. The risk of eye cancer will increase with age.
• Eye color. People who have bright eye color (eg blue, green, or gray) have a higher risk of eye cancer.
• Derivative skin disorders. Skin that has a tendency to form abnormal moles in various areas of the skin (dysplastic nevus syndrome), generally at risk of developing into melanoma in the eyes and skin.
• Nevus of Ota . Nevus of Ota or oculodermal melanocytosis is a condition in which people have a brownish spot on the center of the eye (uvea) or the part between the whites of the eyeballs and the nerves of the eye. People who have Nevus of Ota can be at risk of developing melanoma eye cancer.

Until now, various things that are suspected to be a risk factor for a person experiencing melanoma eye cancer are still being studied, especially environmental and occupational factors. Several types of occupations that are thought to increase a person's risk of developing melanoma eye cancer are:

• Fishermen.
• Workers related to chemicals.
• Laundry workers.
• Farmers.
• Welder.
• Chef.

However, in terms of proof is still debated, because there is no research that states the direct relationship between these types of work with the occurrence of melanoma eye cancer.


Diagnosis of Melanoma Eye Cancer
Melanoma eye cancer is often asymptomatic (no symptoms) so a detailed examination is necessary to confirm the presence of cancer. Several methods of diagnosis that can be done to ensure the presence of this cancer are:

• Eye examination. This examination is done by checking the physical condition of the eyes from the outside of the eyes, blood vessels, and the inside of the eye. Eye examination can also be done by using ophthalmoscopy to see the condition of the inside of the eye.
• Eye Ultrasound . Eye ultrasound serves to provide an overview of the condition of the inside of the eye by using sound waves. The ultrasound device will be placed on the eyelid with closed eye condition.
• Angiogra fi Eyes . Eye angiography serves to map the condition of blood vessels in the eye. Previously, patients will be injected with contrast substances into the blood vessels to map the blood vessels of the eyes and tumors clearly and accurately.
• Biopsy. Biopsy is done by taking samples of eye tissue to detect the presence of cancer cells. However, a biopsy should not always be done to diagnose the presence or absence of melanoma eye cancer in patients, as this action is at risk of damage to the eye.
• Ocular Coherence Tomography (OCT) . This method is done by taking a picture of eye condition using light waves.

To determine the extent of cancer spread, doctors can also perform supportive diagnostic methods such as:

• Chest X-ray.
• Liver function tests.
• Ultrasound abdominal.
• CT scan.
• MRI.

Diagnosis also needs to be done to determine the size of melanoma eye cancer that can be classified as follows:

• Small. If the melanoma tissue has a width of 5-16 mm and a thickness of up to 1-3 mm.
• Medium. If the melanoma tissue has a width of not more than 16 mm with a thickness of about 3.1-8 mm.
• Large If melanoma tissue has a width of more than 16 mm or a thickness of more than 8 mm.

Melanoma eye cancer can be categorized as an advanced stage of cancer if it has spread to other tissues in the eye, or cancer is a recurrence of previous eye cancer that has occurred. The spread of melanoma eye cancer generally occurs in tissues beyond the eyeball (extraocular extension), such as the optic nerve. Recurrent eye cancers can also occur not only in the eyes, but can also occur in other parts of the body such as the liver.

Treatment of Melanoma Eye Cancer
The type of treatment that will be recommended by a doctor is determined by type of eye cancer, tumor size, and spreading rate. The overall age and health of the patient also have a major effect on the type of treatment.

The patient's healing rate is also influenced by these factors, as well as whether melanoma eye cancer has recurrent or not. The level of malignancy of the cancer also affects the possibility of healing the patient so that sometimes doctors need to do eye tissue biopsy in order to know the condition of cancer.

Some methods of treatment of melanoma eye cancer that can be done, among others:

• Surgery. Through this procedure, the doctor will remove the tissue melanoma in the eye. Surgery is done depending on the size and symptoms of cancer caused. If the cancer is small, surgery only removes the cancerous tissue and few healthy tissue around the cancer. Surgery may be iridectomy or choroidectomy. Especially for large cancers, surgery is done to lift the entire eyeball (enukleasi). On the part of the eye whose eyeballs have been lifted can be planted a false eyeball (prosthetic) as a substitute of the previous eyeball.
• Radiotherapy. Through radiotherapy , doctors will fire high-energy radiation beams into cancerous tissue. Radiotherapy is usually used for moderate-sized eye cancer. The source of the radiation beam may come from the radiation plate attached to the eye (brachytherapy) temporarily or from a machine that fires a beam of radiation directly into the eye (external radiation).
• Krioterapi. This is a method of treating eye cancer by freezing the cancer tissue so it breaks and dies.
• Laser therapy. This therapy is done by using special frequency beam. One such example is thermotherapy that treats melanoma eye cancer by using infrared rays. Laser therapy can be combined also with other treatments, especially radiotherapy.
• Chemotherapy. Chemotherapy to treat melanoma eye cancer is done by using drugs to kill cancer cells. However, chemotherapy is rarely used to treat eye cancer.

Opportunities for melanoma eye cancer patients to recover depend on the level of malignancy and size of the cancer. If the cancer is still small or medium, 70-80 percent of people who suffer can still live up to 5 years after diagnosis.

Complications of Melanoma Eye Cancer
If not treated properly, melanoma eye cancer can lead to dangerous complications for patients such as:

• Increased eye fluid pressure (glaucoma). Glaucoma can occur if the melanoma eye cancer grows and results in increased pressure inside the eye bota and damage the eye nerve. Pain and redness in the eyes are a symptom of glaucoma . Glaucoma is also characterized by deteriorating or blurred vision.
• The spread of cancer. Untreated eye cancer melanoma can spread (metastasize) to other body parts, such as the liver, bone, lungs, and brain.
• Blindness eye cancer melanoma, especially large ones, can cause retinal detachment and blindness. However, even small cancers can also cause blindness if it occurs in the eye area that is important for vision.

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