Yes, melanoma can begin growing anywhere in the eyeball, including areas that you cannot see or even feel.
How fast can melanoma grow in an eye is perhaps the first thing that comes to one’s mind when they realize that this cancer usually does not cause eye pain.
It’s a stealthy yet cowardly disease – so often staying silent while it grows.
It can grow for years before it starts causing symptoms — if at all (depending on its exact location).
• Floaters or what seems to be dust specks in your vision
• Flashing lights in your vision
• Blurry or impaired vision in the affected eye
• Loss of peripheral vision
• Visible symptoms: a small brownish patch on the white of the eye; a new mole-like spot on the iris; a lopsided pupil; bulging of the eye.
“There are many parts of the eye where a melanoma can grow – on the front where it’s visible (the conjunctiva), or various parts inside the eye like the iris or the choroid,” says Yuna Rapoport, MD, a board certified ophthalmologist with Manhattan Eye in NYC.
“It grows incredibly slowly in all of these areas,” says Dr. Rapoport.
Removal of the Eyeball
Surgical removal of the eye is called enucleation. So if in general, eye melanoma is very slow-growing, why is it that in some cases, enucleation is the treatment?
Dr. Rapoport explains, “If the ocular melanoma is large by the time it’s found, then enucleation is the chosen treatment.
“The largest melanoma trial, the COMS trial, found that in medium sized tumors, there was no difference in survival between patients who had radiation for their tumor or enucleation.
“So most people in this category just receive radiation. In the larger size tumors, or tumors that involve the optic nerve or cause permanent vision loss, in addition to their specificities markers, enucleation is the treatment of choice.”
How long would eye melanoma have to grow before enucleation is the recommended treatment?
“It really depends on the location (visible in the retina or not visible and hidden in the angle of the eye), if the optic nerve is affected and if vision is affected,” says Dr. Rapoport.
If ocular melanoma is discovered early enough (incidentally in a routine eye exam or visibly by the patient as a spot on the eye) and is not causing symptoms, an ophthalmologist may recommend ongoing surveillance of a small tumor and monitoring if it grows larger or starts causing symptoms.