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Melanoma is the most common type of eye tumor in adults. Even so, primary melanoma of the eye is rare.

Excessive exposure to sunlight is a large risk factor. The occurrence of melanoma has greatly increased in recent decades, and fair-skinned and blue-eyed people are most often diagnosed.

Most cancers of the iris, ciliary or choroid are initially completely asymptomatic. As the tumor enlarges, the tumor may cause distortion of the pupil (iris melanoma), blurred vision (ciliary body melanoma) or markedly decreased visual acuity from a secondary retinal detachment caused by a choroidal melanoma.

Treatment

Melanoma can be detected by routine ophthalmic examination that includes dilation of the pupil and detailed examination of the posterior aspect of the eye to detect choroidal melanomas. Like most early cancers, an early melanoma is usually a silent cancer. Small melanomas may be treated with lasers, brachytherapy, or radiation therapy. Enucleation may be necessary.

The prognosis depends on the size and cell type of the cancer, where the cancer is in the eye, and whether the cancer has spread.