Introduction:
Melanocytes are the cells that produce melanin pigment - the pigment that produces skin color. They absorb light and protect the tissues from ultraviolet light. Melanomas are cancer cells that come from melanocytes. These melanomas are also called ocular melanoma. Conjunctival melanoma can be as small as one millimeter in diameter to a large untreated mass covering the entire surface of the eye. According to the studies, conjunctival melanomas are commonly observed in North American people and appear as nodular or diffuse growth. A melanoma differs from a mole or a nevus. Ocular melanomas can range in color from dark to light brown, or orange, or have no color at all. They are thicker than usual and can leak fluid. Conjunctival melanoma is extremely uncommon even though it is the most prevalent eye cancer in people.
Where Does Ocular Melanoma Commonly Occur?
Ocular melanoma frequently develops in the middle layer of the eye, commonly known as the uvea. The uvea consists of three parts, and each part can be affected by melanoma:
-
The Conjunctiva - The outermost layer of the eye.
-
The Choroid Layer - The layer of blood vessels and connective tissues located between the sclera and the retina.
-
The Ciliary Body - It is in front of the uvea and secretes a transparent liquid (aqueous humor) into the eye.
-
The Iris - The colored part that is at the front of the eye containing the pupil.
What Are the Causes of Conjunctival Melanoma?
Conjunctival melanoma is caused by a defect in the deoxyribonucleic acid (DNA) of the pigmented cells of the eye. This causes the cells to multiply uncontrollably. Melanoma is created when the mutant cells assemble in or around the eye.
What Are the Symptoms of Conjunctival Melanoma?
There may be no symptoms or indicators of conjunctival melanoma. The signs and symptoms of conjunctival melanoma can include the following when they do appear:
-
Appear as various shades of brown but also can appear amelanotic or pink.
-
Blurred or uncleared vision.
-
Flashlight sensations.
-
A change in the shape of the pupil.
What Are the Risk Factors of Conjunctival Melanoma?
The various risk factors of conjunctival melanoma include:
-
Light Colored Eyes - Conjunctival melanoma is more likely to develop in people with blue or green eyes.
-
Age - Age is a risk factor for conjunctival melanoma. It may increase with advanced age. Conjunctival melanoma is commonly seen in older people.
-
Certain Skin Disorders - The risk of getting melanoma on the skin and in the eyes may increase if a person has dysplastic nevus syndrome, a disorder that results in atypical moles.
-
Sunlight Exposure - Exposure to ultraviolet light such as sunlight or sun beds may increase the risk of conjunctival melanoma.
-
Genetics - Certain genes which are transferred from parent to child may increase the risk of conjunctival melanoma.
What Is the Diagnosis of Conjunctival Melanoma?
Conjunctival melanoma is diagnosed by different methods, such as:
Diagnosing ocular melanoma begins with a dilated eye exam by an ophthalmologist, because ocular melanoma may not initially cause any symptoms, the disease is often detected during an eye check-up.
-
Fluorescein Angiography - A dye is injected into the patient's arm during this treatment and goes to the eye. Then, to check for blockages or leaks, a special camera is used to capture images of the interior of the eye.
-
Fundus Autofluorescence - This technique makes use of a unique form of camera that reveals the areas of damage as small points of light in a photograph.
-
Optical Coherence Tomography - This imaging technique may produce highly detailed pictures of the inside of the eye.
-
Biopsy - The cancer cell (melanoma) is removed from the surface of the eye. After that, the tissue is evaluated and examined in a laboratory. Ocular melanoma can be diagnosed without a biopsy, but it may capture information about the tumor and if it might spread to other body parts.
-
Ultrasound Examination of the Eye - Ultrasound uses high-energy sound waves to examine the eye by creating echoes as they travel through the internal tissues. A small probe that transmits and receives sound waves is gently put on the eye’s surface after using eye drops to numb the eye. The echoes provide a picture of the eye's interior.
What Treatment Options Are Available for Patients With Conjunctival Melanoma?
The treatment options vary depending on:
-
The location and size of the melanoma.
-
The general health of the person
Radiation and surgery are the two main types of treatment available:
1. Conjunctival Melanoma Radiation -
Different forms of radiation are used in radiation therapy to either kill or stop the growth of melanoma. Plaque radiation therapy is the most popular method of radiation treatment for ocular melanoma. Plaques, which contain radioactive seeds, are implanted directly on the eye's wall near the tumor. Frequently, the plaque, which resembles a miniature bottle cap, is made of gold. By doing this, the doctors may shield the neighboring tissues from radiation that is being used to treat the tumor. The plaque is held in place for four or five days by temporary stitches before being taken out.
2. Conjunctival Melanoma Surgery -
Conjunctival melanoma surgery depends on the size and location of the tumor. If the tumor is big, and it causes eye pain, or affects the optic nerve then the entire surface of the tumor and also surrounding healthy tissue may need to be removed during surgery. After the eye is removed, it is recommended to replace it with an implant that is connected to the eye muscles in order for the implant to move. After the recovery from the procedure, an artificial eye is installed (prosthesis). It will be painted specifically to match the natural eye. The eyesight can be harmed by radiation and surgery. Due to the bleeding and swelling after the surgery may raise the pressure inside the eye (ocular hypertension), as well as radiotherapy, may damage the blood vessels and cause bleeding.
Conclusion:
Melanomas are the cancer cells that arise from the transparent membrane that lines up the surface layer of the eye. Conjunctival melanoma is caused by a defect in the deoxy ribonucleic acid (DNA) of the pigment cells of the eye. This causes the cells to multiply uncontrollably. It is better if the patient consults a doctor immediately when they find out any symptoms related to conjunctival melanoma to prevent any further complications of the same.
