Melanoma Eye Cancer

Melanoma is a cancer that occurs in melanocyte eye cells that produce melanin. Melanin is a pigment that produces color on the skin, hair and eyes. Therefore, melanoma can also occur on the skin.

 Melanoma in the eye usually develops in the eye tissue of the eye, which includes the iris tissue of the eye, the body of the cilia, and the choroidal tissue. Melanoma eye cancer often occurs in parts of the eye that are not visible during reflection. In addition, this cancer rarely causes specific symptoms at an early stage. Both of these factors make melanoma eye cancer difficult to detect at an early stage and are usually discovered accidentally during routine eye examinations. But as the cancerous tissue grows, there is a change in pupil shape, blurred vision and reduced vision.

Melanoma eye cancer can be treated properly, especially if it is still in the early and small stages. Small cancer treatments rarely interfere with the patient's ability to see. Conversely, if the cancer is large, the treatment can cause interference with the patient's vision.

Symptoms of melanoma eye cancer
Most ocular melanomas develop in the eye, which tend to be invisible, making them difficult to detect. This cancer also rarely causes significant symptoms. If an indication appears, it is usually in the form of:

• Black dots appear on the iris.
• It feels like seeing a flash of light.
• There are spots or lines that obstruct the display.
• Blurred vision or loss of vision.
• Pupil shape changes.
• Swelling in one eye
• The pieces on the eyelids or eyeballs are getting bigger and bigger.

Although these symptoms can also occur not because of melanoma, but if you experience these symptoms, it is recommended that you immediately consult an eye specialist.

Causes and risk factors for melanoma
Melanoma-related eye cancer is caused by changes or mutations in eye melanocyte cells, resulting in uncontrolled cell growth. Melanoma tissue with uncontrolled growth damages healthy eye tissue.

Melanoma can occur in various parts of the eye, either in the front, such as the iris and ciliary body, or behind, or more precisely in choroidal tissue. But in rare cases, melanoma cancer can develop before the eyes, especially in the conjunctiva.

Genetic mutations in eye cells are unclear, but several factors are thought to trigger them, including:

• White skin.
• Exposure to sunlight and ultraviolet light, including frequent use of ultraviolet (tanning beds) to darken the skin (tanning). But that can't be proven with certainty.
• Age factor. The risk of eye cancer will increase with age.
• Eye Color People with bright eye colors (for example, blue, green or gray) have a higher risk of developing eye cancer.
• Hereditary skin disorders. Skin that tends to form abnormal moles in various areas of the skin (neviplastic syndrome) tends to develop melanoma in the eyes and skin.
• Nevus of Ota. Ota nevi or oculodermic melanocytosis is a condition characterized by brown spots in the middle part of the eye (uvea) or in the part between the white part of the eyeball and nerve of the eye. People with Ota nevi may be at risk of developing melanoma eye cancer.

To date, various factors that can be considered risk factors for someone with melanoma eye cancer are still under study, including environmental and occupational factors. Some types of work that are considered to increase the risk of developing melanoma eye cancer are:

• Fisherman.
• Workers dealing with chemicals.
• Laundry worker.
• the farmer
• welder
• Chef

But in terms of evidence, the debate still reverberates, because there is no research that establishes a direct relationship between this type of work and the occurrence of eye cancer by melanoma.
Diagnosis of melanoma eye cancer

Because melanoma is an eye cancer that is often asymptomatic (asymptomatic), a detailed examination is needed to confirm the presence of cancer. Some diagnostic methods that can be done to confirm the presence of this cancer are:

• Eye examination. This examination is done by examining the physical condition of the eye from the outside, blood vessels and the inside of the eye. Eye examination can also be done using ophthalmoscopy to determine the condition of the interior of the eye.
• Ultrasonic eye. Ocular ultrasonic is used to provide insight into the inner state of the eye using sound waves. An ultrasound machine will be placed in the eyelid, eyes closed.
• Eye angiography. Eye angiography is used to map the condition of blood vessels in the eye. Previously, patients would receive contrast agents in blood vessels to map them clearly and accurately.
• Biopsy. Biopsy involves collecting eye tissue samples to detect the presence of cancer cells. However, biopsy is not always done to diagnose the presence or absence of melanoma eye cancer in patients, because this action can cause eye damage.
• Eye coherence tomography (OCT). This method is done by taking pictures of eye conditions using light waves. 

To determine the extent of cancer spread, doctors can also apply complementary diagnostic methods such as:

• Chest radiograph.
• Liver function test.
• Gastric ultrasonography.
• Scanner.
• MRI

A diagnosis must also be made to determine the size of eye cancer with melanoma, which can be classified as follows:

• Small If melanoma has a width of 5-16 mm and a maximum thickness of 1-3 mm.
• Do If melanoma has a maximum width of 16 mm and a thickness of about 3.1 to 8 mm.
• Super If melanoma is wider than 16 mm or larger than 8 mm.

Ocular melanoma can be classified as advanced cancer if it has spread to other ocular tissue, or if the cancer recurs (recurred) anterior cancer of the eye. Spread of eye cancer by melanoma usually occurs in tissue outside the eyeball (extra ocular extension), such as the optic nerve. Recurrence of eye cancer can also occur not only in the eye, but also in other body parts, such as the liver.
Treatment of melanoma eye cancer

The type of treatment recommended by a doctor depends on the type of eye cancer, the size of the tumor and the extent of its spread. The patient's age and general health also have a large influence on the type of treatment.

The patient's recovery rate is also influenced by these factors, as well as by recurrence or eye cancer by melanoma. The level of cancer malignancy also affects the patient's ability to heal, so doctors sometimes need to take a biopsy of the eye tissue to find out the condition of the cancer.

Several methods of treating melanoma eye cancer can be applied, including:

• Surgery With this procedure, the doctor will remove melanoma from the eye. The surgery performed depends on the size and symptoms of the cancer. If the cancer is small, surgery can only remove cancerous tissue and some healthy tissue around the cancer. Surgery can be in the form of iridectomy or choroidectomy. For large cancers, surgery is performed to remove the entire eyeball (enucleation). Fake eyeballs (prosthetic) can be implanted in the eye where the eyeball is removed, replacing the previous eyeball.
• Radiotherapy. Through radiation therapy, doctors will emit high-energy radiation rays into the cancerous tissue. Radiation therapy is generally used for medium-sized eye cancer. The source of radiation can come from radiation plates that are stuck in the eye (brachytherapy) for a moment or from a machine that emits a beam of radiation directly to the eye (external radiation).
• Cryotherapy. This is a method of treating eye cancer by freezing cancerous tissue so that it is damaged and dies.
• Laser therapy. This therapy is carried out using a special frequency beam. For example, thermotherapy treats melanoma eye cancer using infrared light. Laser therapy can be combined with other treatments, including radiation therapy.
• Chemotherapy. Chemotherapy to treat melanoma from eye cancer is done by using drugs to kill cancer cells. However, chemotherapy is rarely used to treat eye cancer.

The risk of surviving melanoma depends on the severity and size of the cancer. If the cancer is still small or moderate, 70 to 80% of those affected can still live up to 5 years after diagnosis.
Complications of melanoma eye cancer

If not treated properly, melanoma eye cancer can cause life-threatening complications for patients, such as:

• Increased eye pressure (glaucoma). Glaucoma can occur if melanoma increases eye cancer and causes increased eye pressure and ocular eye damage. Pain and redness of the eyes is a symptom of glaucoma. Glaucoma is also characterized by visual impairment or blurring.
• Spread of cancer. Untreated melanoma eye cancer can spread (metastasize) to other parts of the body, such as the liver, bones, lungs and brain.
• Melanoma blindness, especially larger ones, can cause retinal detachment and blindness. However, even a small cancer can cause blindness if it occurs in the part of the eye that is important for vision.

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