Perhaps you know that generally, eye melanoma is slow growing and may even be left in and just monitored. So why does it have a high mortality rate?

“The mortality of melanoma varies depending on where in the eye it is located,” says Yuna Rapoport, MD, a board certified ophthalmologist with Manhattan Eye in NYC.

It also depends on the size of the tumor and what type of cell it’s proliferating in, says Dr. Rapoport.

“Uveal melanomas vary in mortality between 16-53 percent at five years, depending on the size.”

Delayed Diagnosis

Dr. Rapoport explains, “Ocular melanoma has high rates of metastases when there is a delayed diagnosis. This is what causes the high death rate.”

This cancer spreads to the liver in 80+ percent of metastatic cases. Other sites for spreading include the lungs, brain and bones.

“Additionally, there are certain chromosomal markers of various tumors that can cause a higher mortality rate as well,” says Dr. Rapoport.

Of course, the earlier any cancer is diagnosed, the more favorable the prognosis.

Melanoma of the eye is one of those cancers whose symptoms can remain under the radar in that they don’t seem all that alarming.

For example, one possible symptom is floaters, which can be dismissed by the patient.

Another symptom that can be brushed off is a worsening of vision that the patient might think is just a normal change in prescription for someone who wears corrective lenses.

They may postpone a visit to an eye doctor for any number of reasons.

Furthermore, the optometrist or ophthalmologist may not suspect cancer if the patient’s only complaint is something like, “I think I need a new prescription.”

Another explanation is that the tumor may only be visible if one is looking closely at their eye. Men are less likely to do this since they don’t wear eye makeup.

A small growth in the iris can go unnoticed. So may a growth on the white part of the eye, especially if the lid conceals it.

“Melanoma can sometimes hide in the angle of the eye and is hard to find,” says Dr. Rapoport.

“That is why a thorough examination with an ophthalmologist, looking at the angle using a special lens called a goniolens, is important if one eye has higher pressure than the other or if it has more inflammation than the other.”

Many ocular melanomas are simply caught at a later stage, when they have spread – when mortality is more likely.

There are also cases in which distant, never detected metastases don’t start causing symptoms until years after the treatment for the original eye tumor is completed.

Yuna Rapoport, MD

Manhattan Eye uses state of the art LASIK technology and modern techniques for a safer and more precise correction surgery, and also provides services covering all aspects of eye health.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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