How worried should I be about an eye freckle?

A freckle in your eye might seem odd, but they're actually common and usually harmless. If you have one, your eye doctor may want to watch it over time. It's rare, but they can turn into a type of cancer called melanoma.
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What percentage of eye freckles are cancerous?

It is a flat pigmented lesion that is benign, with roughly one in 10 people developing this type of nevus. Although it is generally noncancerous, a choroidal nevus still has a small potential to become cancerous. That is why it needs to be followed by your eye doctor.
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How do I know if my eye freckle is cancerous?

When they do occur, signs and symptoms of eye melanoma can include:
  1. A sensation of flashes or specks of dust in your vision (floaters)
  2. A growing dark spot on the iris.
  3. A change in the shape of the dark circle (pupil) at the center of your eye.
  4. Poor or blurry vision in one eye.
  5. Loss of peripheral vision.
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How rare is it to have a freckle in your eye?

When the eye freckle is on the iris (the colored part of the eye), it's called an iris nevus. Approximately 6 in 10 people have one.
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What does having a freckle in your eye mean?

Called a nevus (or nevi, in the plural), an eye freckle looks like just that: a small spot on the surface of your eye. Although you might be alarmed when you first see it, it's good to know that it's most likely completely harmless and nothing to worry about.
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Nevus in the Eye – Could It Mean Cancer? | Tara McCannel, MD, PhD | UCLAMDChat



How common is melanoma in the eye?

Ocular melanoma is the most common primary cancer affecting the eye. However, it is a rare disorder and is estimated to be diagnosed in about 2,500 people in the United States each year. The incidence is unknown, but one estimate places it at about 5-6 people per every 1,000,000 people in the general population.
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Is eye melanoma curable?

These rare cancers can be treated with either surgical removal of the tumor, if it is small enough, or radiation therapy. In more advanced cases or if there is serious eye damage, enucleation (removal of the eyeball) may be needed.
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Can a nevus appear suddenly?

Moles, or nevi, typically form during childhood and adolescence, but new moles can appear in adulthood. Although most moles are noncancerous, or benign, the development of a new mole or sudden changes to existing moles in an adult can be a sign of melanoma.
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Can an eye freckle be removed?

Can a nevus be removed? Because nevi don't affect your vision or cause health problems, they usually don't need to be removed. In fact, removal could do more damage than good. However, if a nevus becomes cancerous, your ophthalmologist may recommend it be removed with radiation therapy or surgery.
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How can you tell the difference between a melanoma and a choroidal nevus?

Choroidal nevi are slate-gray and relatively flat (less than 2mm thickness), although there is significant size overlap between small melanomas and larger nevi. Like choroidalal melanomas (i.e. full-blown eye cancers), they also may show overlying drusen or lipofuscin (figure 2).
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Is ocular melanoma a death sentence?

Choroidal melanoma is a disease with a high mortality rate, usually irrespective of the chosen treatment modality. About 30-50% of patients with choroidal melanoma will die within 10 years from diagnosis and treatment. Death is usually secondary to distant metastases, and the risk is greatest in larger tumors.
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How long does it take ocular melanoma to spread?

Approximately 50% of patients with OM will develop metastases by 10 to 15 years after diagnosis (a small percentage of people will develop metastases even later i.e. 20-25 years after their initial diagnosis). Metastatic disease is universally fatal.
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What does iris melanoma look like?

Circumscribed iris melanomas appear as a variably pigmented well-defined mass in the iris stroma and is more commonly found in the inferior half of the iris. The degree of pigmentation can vary as well as the shape. Some are small and flat and others are elevated and dome shaped.
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Can freckles turn into melanoma?

Freckles 101

Freckles are actually evidence of a genetic mutation in your “freckle gene.” No, you're not an alien, but when this gene (called the melanocortin one receptor gene) is mutated, you are at greater risk for predisposed skin cancer — both melanoma and non-melanoma types.
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What do brown spots in your iris mean?

Summary: In a study well-timed for summer, vision scientists have found that eye freckles, dark spots on the colored part of the eye (iris), are more frequently found in people with higher lifetime exposure to sunlight.
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How often should a choroidal nevus be checked?

All choroidal nevi should be examined at least once a year. If your doctor notices certain features on your nevus, you may need to be checked more often. For example, if the nevus is particularly large or thick, has orange pigment, or is leaking fluid, then it is more likely to grow into a melanoma.
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Are eye freckles harmless?

A freckle in your eye might seem odd, but they're actually common and usually harmless. If you have one, your eye doctor may want to watch it over time. It's rare, but they can turn into a type of cancer called melanoma. So whether they're old or new, it's always a good idea to get them checked out.
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How do you get rid of eye freckles?

If melanoma is suspected, your eye doctor will recommend an excisional biopsy, in other words removing the pigmented lesion surgically. The resulting hole in the conjunctiva is closed with dissolvable sutures, surgical “glue”, or laser cautery, depending on its size and location.
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Do brown spots on eyes go away?

In the above cases, a brown spot on your eye can be removed. Treatment options include radiation, surgery, laser therapy, or removal of the eye in severe cases. Your doctor may also just want to wait and observe any changes to the spots on your eyes.
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When should you get a freckle checked?

A mole or freckle should be checked if it has a diameter of more than a pencil eraser or any characteristics of the ABCDEs of melanoma (see below). Dysplastic nevi are moles that are generally larger than average (larger than a pencil eraser) and irregular in shape.
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What does Stage 1 melanoma look like?

Stage IA Melanoma: The melanoma tumor is less than 1.0 millimeter thick (less than the size of a sharpened pencil point) with or without ulceration (broken skin) when viewed under the microscope. Stage IB Melanoma: The melanoma tumor is more than 1.0 millimeter and less than 2.0 millimeters thick without ulceration.
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What does early signs of melanoma look like?

What to look for: Usually, the most obvious warning signs of early stage melanoma are changes to your moles or spots: in size, shape, colour or in how they look or how they feel. Melanoma can also appear as a new mole (more commonly in people aged 50 years or more)2.
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Is eye melanoma fatal?

The 5-year survival rate for eye melanoma is 82%. When melanoma does not spread outside the eye, the 5-year relative survival rate is about 85%. The 5-year survival rate for those with disease that has spread to surrounding tissues or organs and/or the regional lymph nodes is 71%.
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Does an eye biopsy hurt?

After you have the local or general anaesthetic, the specialist puts a thin needle attached to a syringe into your eye. They draw out some cells from the tumour. This usually takes a few minutes. If you have a local anaesthetic you may be aware of something going on, but you shouldn't have discomfort or pain.
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