Ocular Melanoma Diagnosis

And when you come to us for ocular melanoma care, we start by ensuring you have a thorough and precise diagnosis because that’s the key to selecting the most effective treatment.

Ocular melanoma can be diagnosed by an experienced eye doctor with a dilated eye exam. But we don’t stop there. We’ll analyze your cancer on a molecular level to determine what’s driving it and how likely it is to come back — so we can figure out the best way to stop it. 

Although rare, ocular melanoma is the most common type of cancer that develops within the eye in adults. It originates in the pigment-producing cells of the eye and can occur in various parts, including the uvea (iris, choroid, and ciliary body) and the conjunctiva.

Other types of eye cancer include:

• Retinoblastoma (or Retinal Tumors): This rare cancer primarily affects young children, usually under the age of 5, originating in the retina, the light-sensitive tissue at the back of the eye.
• Lymphoma: Primary intraocular lymphoma, a type of non-Hodgkin lymphoma, typically involves the retina, vitreous humor, and optic nerve.
• Ciliary Body Tumors: These tumors develop in the ciliary body, responsible for producing the eye's nourishing fluid and maintaining its shape. They can be benign or malignant.
• Conjunctival Tumors: Malignant cancers that grow on the outer surface of the eye, including squamous cell carcinoma, conjunctival melanoma, lymphoma, and carcinoma-in-situ, originate from the thin membrane covering the white part of the eye and the inside of the eyelids (conjunctiva).
• Orbital Tumors: These tumors, benign or malignant, can start in the eye socket (orbit) or spread to it from nearby structures, potentially affecting eye movement or causing bulging.

Winship and Emory Eye Center take a multi-stage approach to ensure every patient gets a thorough and accurate ocular melanoma diagnosis. Because no two eye cancers are the same — even those that are the same type — your cancer will differ from another person’s. And it’s imperative we understand your cancer to properly treat it. We’ll begin planning and administering your treatment right away, while we continue to investigate what’s causing your ocular melanoma and if and where it has spread.

Ocular melanoma is one of the only cancers that can be diagnosed by exam alone — as long as you go to a skilled eye doctor. Experienced ophthalmologists, like the ones at Emory Eye Center, can identify ocular melanoma during a dilated eye exam.

At the same time, patients may be referred for imaging to determine if the cancer has spread to other parts of the body. When ocular melanoma metastasizes, it almost always spreads to the liver first. So, your ophthalmologist likely will order a computed tomography (CT) scan of the abdomen to check for metastatic disease.

Next, your eye doctor will use ocular ultrasound to take measurements of your eye and the cancer to inform your treatment plan.

Emory Eye Center offers all ocular melanoma patients the option of biopsy, or taking a sample of the cancer, and testing it in a lab. While biopsy is not necessary to obtain an ocular melanoma diagnosis, it can be used for gene expression profiling, which can tell you how likely it is your cancer will return or spread. Eye cancer biopsies have inherent risks and should only be performed by highly skilled ophthalmologists. Emory Eye Center is one of only a few centers in the region to offer biopsy for ocular melanoma.

Patients with ocular melanoma are at greatest risk for metastasis within two to five years from the time that they are diagnosed. A baseline screen consisting of a CT scan of the chest, abdomen, and pelvis is performed after diagnosis. The most common site of metastasis is the liver, although other organs including the lung may be involved.

If your ocular melanoma has spread, it is highly recommended to make an appointment with one of our experienced medical oncologists who can review your case and make appropriate recommendations. Your ocular oncologist and medical oncologist will work hand-in-hand to provide the best care you deserve.