Eye melanoma is the cancer of the eye. Most often the disease is treated with radiation.

The most common form of eye melanoma is called uveal melanoma. Then the disease begins in a part of the eye called the grape, which is also called the uvea. This text is about uveal melanoma.

What is eye melanoma?

Eye melanoma is cancer in cells called melanocytes. Melanocytes are found, for example, in the skin and eyes. Cancer occurs when cells are damaged and changed. The cells divide uncontrollably and form cancerous tumors that displace healthy tissue.

Eye melanoma is uncommon. Most people who get the disease are older than 50 years, but even younger people can get it. It is not known why you get eye melanoma. Unlike skin cancer disease malignant melanoma, eye melanoma does not depend on too much sunburn.

It is very uncommon for eye melanoma to spread to the other eye. But the disease can spread to other parts of the body. Then it is most common for the disease to spread to the liver.

Symptoms of eye melanoma

The symptoms of eye melanoma are often not so clear. Sometimes you get no symptoms if the tumor is small. The symptoms may resemble retinal detachment. Then you can experience some of these hassles:

  • You can see flashes of light on the outer edge of the field of view.
  • You may find that your field of vision is getting smaller. For example, you can see a dense shadow that obscures part of the field of view.
  • Visual acuity may become blurred and straight objects may appear curved.

It doesn’t usually hurt the eye.

Sometimes eye melanoma does not cause any symptoms at all, but the disease is detected if your eyes are examined for any other reason.

When and where should I seek care?

If you see lightning on the edge of the field of vision, contact a  health care center or an on-call reception. You can also contact an eye reception directly. If it’s night, you can wait until the on-call reception or medical center open.

If it’s in a hurry

If you see a grayish or dark shadow on the edge of the field of vision, contact a health care center or an on-call reception immediately. If closed, seek medical attention at an emergency room.

Investigations

The doctor examines your eyes if they suspect you have eye melanoma. Then you have to do a thorough eye examination. The doctor examines the scalp and makes an ultrasound of the eye. The survey takes about an hour. It does not hurt but can feel exhausting because you have to sit still. You may get tired in the eyes afterward.

You also get a referral to do an ultrasound examination of the liver and a  pulmonary x-ray. This is done to exclude the spread of the disease.

Getting a cancer message

You can respond to a cancer message in many different ways. You often need plenty of time to talk to your doctor and other healthcare professionals about what the message means. If possible, please let a relative accompany you. The related person can act as a support and help to remember what has been said.

You can also ask to have the information written down so that you can read it peacefully. Ask questions if you don’t understand. You have the right to receive information in your own language. You also have the right to receive interpreting assistance if you have a hearing impairment.

You can get help in several places

Are you worried or have questions? Talk to the hospital’s curator.

You can also contact for example the Cancer Foundation or Cancer Counseling.

Here you can read more about how you can get help and support in cancer.

For many, it usually feels easier once treatment has begun and they know what is going to happen.

Tell the children about your illness

An underage child living at home has the right to receive information and support based on his or her own needs. It is the responsibility of care. If you want to tell the child yourself about your illness, you can get help with what to say. Often it is good to make children as involved as possible, no matter how big or small they are. That doesn’t mean you have to tell everything.

Support if you are related

It can sometimes feel difficult to be close to someone who is ill. Maybe you want to give support while you have a strong concern and feel bad? It is very common to do so.

Maybe there are other people in your area who can support you? Often it will be easier for them to help you if you dare to tell them how it feels.

You can read more in the texts  Getting a Cancer Message and Related to someone who gets cancer.

Treatment for eye melanoma

The treatment for eye melanoma you receive depends on the size of the cancer tumor, where it is located and whether it has spread. The most common treatment is radiation with a radiation plate.

Sometimes the eye may need surgery.

Most people who get eye melanoma are treated at St Erik’s Eye Hospital in Stockholm.

Radiation plate treatment

Eye melanoma can be treated with radiation. Then a so-called jet plate with a radioactive substance is operated into the eye. The radiation plate ensures that the cancer tumor receives intensive and uniform irradiation for an extended period of time for the tumor to collapse and shrink. The operation when you get the radiation plate is done under anesthesia.

It varies how long you need to have the beam plate in your eye. It can be from a few days to a week. Then the jet plate is removed, then you also get anesthesia. 

This is how the treatment works

When treated with the radiation plate, the tumor itself and some healthy tissue surrounding the tumor are radiated. After treatment, the eye may become red, irritated and vision may change. It may be chafing during the time you are being treated and a few weeks afterward but it usually does not work. Most people need to be on sick leave during treatment. Some need to stay in the hospital. It depends on the type of plate used. 

After the treatment with the radiation plate

After removing the radiation plate, you may need to take eye drops to reduce the inflammation of the eye that may occur during radiation treatment.

Sometimes laser treatment is needed as a complement

Sometimes the radiation treatment needs to be supplemented with a laser treatment. This may be because the tumor is located in a place where the radiation plate has difficulty reaching it. The laser treatment is done either when the plate is inserted or later.

Remove the eye

The eye may sometimes need to be removed if the tumor is large or sits in a place that does not treat radiation. The operation is done under anesthesia and takes about two hours. It is common to stay one night in the hospital after the operation and return home the morning after the operation.

You get a temporary implant

You will receive an implant that will fill the eyelid after the eye has been removed. The implant is not visible and is not felt.

During the operation, a thin plastic disc is also inserted under the eyelid. It keeps the eyelids in shape. The plastic disc should remain in place until an eye prosthesis can be inserted. Immediately after the operation, you receive a pressure bandage over the eyelid. It should remain until the following day.

Eye ointment for two weeks

After the surgery, the eyelid is closed and it looks like you are closing your eyes. The first two weeks after the operation, you get an ointment that you have to lubricate on the inside of the eyelid.

You can live as usual

You can live as usual after the surgery and wash your face, shower and wash your hair as usual. If it is sticky in the eyeball, you can wash it with a compress. 

Post-operative complications

You should contact a health care center or an on-call hospital if you have any of the following problems after the operation:

  • You get severe pain in the eye.
  • You become more swollen or red in the eyelids or eyelid.

If closed, seek medical attention at an emergency room.

After the treatment

What happens after the treatment depends on whether you were treated with a jet plate or if the eye was removed.

After treatment with radiation plate

You who have been treated with a radius plate may go under control one month after the operation when the plate is removed. After that, you will be in control after about three, six and twelve months. It usually takes up to six months for the doctor to see the effect of radiation therapy.

You get to go on an annual check

You may go to check once a year for the rest of your life if the cancer is gone. During the checks, your eyesight is examined, among other things. Sometimes an ultrasound examination and an eye scan are also done.

The jet plate gives you a scar on the bottom of the eye. This can make visual acuity worse than before surgery. Your field of view may also be smaller than it was before treatment.

Getting an eye prosthesis

It can be shocking to have to remove an eye and start using an eye prosthesis. It may feel a little unfamiliar at first but most get used to it for a while. It doesn’t hurt to have an eye prosthesis.  

About four weeks after surgery, you will meet a prosthetic technician to help you try out an eye prosthesis. 

Two types of dentures

There are two types of eye prostheses, in plastic or in a glass. A plastic prosthesis takes a few weeks to make and you may need to meet the prosthetic technician on several occasions to try it out.

You can often get a glass prosthesis on your first visit to the protest technician. A plastic prosthesis is more durable than a glass prosthesis, but the glass prosthesis is lighter. They also last for a long time. A plastic prosthesis lasts four to five years but sometimes even longer than that. A glass prosthesis should be replaced after two to three years. The eye prosthesis may remain for a long time, but you may need to remove it occasionally to wash it.

You can often live as usual

Many who have eye prostheses can live as they did before the surgery. They depend on how the vision is on the other eye. If you usually drive a car, you must wait six months after the eye has been removed before you can drive again.

Post-check of the liver was every six months for the first five years

For the first five years, you will have to check for a liver ultrasound every six months. This applies regardless of whether you have received radiation therapy or if your eye has been removed.

If the disease has spread or comes back

Eye melanoma can spread. The disease can also come back, sometimes several years after you became ill. If the disease has spread, it is most common to get sick in the liver.

Treatment of the disease has spread or come back

If the disease has spread and formed metastases, also called daughter tumors, the disease cannot be cured. You can get treatment with anti-cellulite drugs, also called cytostatic drugs. You may also need surgery. Sometimes both cytostatics and surgery are needed. There is also a special treatment when you receive high doses of cytostatic drugs to the liver and that does not affect other organs in the body.

Sometimes the disease cannot be stopped, then you will receive treatment that relieves the problems you have. It is called palliative care 

Muhammad Nadeem

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