I saw a 32 year old female for her first eye exam. She had no complaints and her vision was 20/20 in both eyes. She was seen on the mobile clinic because she “never had time for an eye exam.” She presented with a chief complaint of “nothing, I can see fine, I just wanted to do it today because I have insurance and it’s convenient.” A closer look at her retina revealed a freckle, which turned out to be an early choroidal melanoma (eye cancer). I asked the patient if she happened to have a family history of skin cancer. She replied, “Yes, and breast cancer.”
Most choroidal melanoma patients have no symptoms and the melanoma is found on a routine eye examination. Choroidal melanoma can be seen by ophthalmoscopy (when your eye doctor looks through a lens into your dilated pupil). Similar to like-sized melanoma of the skin, patients are much more likely to survive a choroidal melanoma. This is because it is much more difficult for a choroidal melanoma to spread from the eye to other parts of the body. However, large tumor size increases the risk of permanent vision loss. In general, the larger the choroidal melanoma the worse the prognosis for both vision and metastasis (spreading to other areas).