Treatment for the Intraocular Melanoma Dilemma

How frequently do you hear about people getting eye cancer? Well, sore eyes and broken blood vessels at the back of the eye are fairly common, but cancer of the eye?

Intraocular melanoma is said to be the most common type of eye cancer among adults. When one’s growing old plus fair-skinned with light-colored eyes, it adds to the risk of intraocular melanoma. However, according to Johns Hopkins Medicine, it’s still rare. Rare can give you a bit of a fright because it doesn’t manifest as life-threatening right away.

As introduced in a former blog, intraocular melanoma begins in cells called melanocytes. These melanocytes don’t become cancerous right away. Of course, one can imply that these cells get cancerous as you reach mid-50s, especially noting the color of your skin and eyes. But young dark-skinned individuals can get the disease, as well. Reading this, you might be a little late to consider all the possibilities rather than mere general information.

So this article is going to focus on the different kinds of treatment for intraocular melanoma. 

After taking the physical exam and medical history assessment, eye examinations, and ultrasound, there are various treatments for intraocular melanoma patients that target one or all three main parts of the uvea, the middle layer of the eye’s wall where intraocular melanoma develops. These procedures include:

Standard Treatments

  • Radiation Therapy
  • Watchful Waiting
  • Surgery
  • Photocoagulation
  • Thermotherapy

Radiation Therapy

It’s a cancer treatment that uses high-energy waves such as X-rays, electron beams, or protons, to exterminate cancer cells or prevent them from forming. You can have internal radiation therapy or external beam therapy. The former consists of stitching a tiny radioactive disc to the eye, which is a source of high radiation to the cancer in the eye. From the term itself, the latter is an external machine that directs radiotherapy beams at the eye cancer, so no device is penetrating the eye.

Watchful Waiting

Whereas radiation therapy sounds invasive, watchful waiting is more of a passive approach. It’s closely surveilling a patient’s condition without providing any treatment until causes or symptoms surface or alter. Photos are taken to monitor the changes in the size of the tumor and the speed of its growth. As has been said, intraocular melanoma means the presence of malignant cancer cells in the eye tissues, so if there are no signs and symptoms of that or there are tumors but not cancerous and expanding, watchful waiting is used. It’s extra useful when potential cancer cells only exist in the eye with clear vision.


Needless to say, surgery is the most practical and common procedure. It’s good to know that there are stages in surgically treating intraocular melanoma. The operation consists of:

  • Resection – surgery to pull out the tumor and a small amount of healthy tissue surrounding it.
  • Enucleation – surgery to pull out the eye and part of the optic nerve. This is done as a last sort when vision is utterly lost, and the tumor has grown to an alarming degree that it has damaged the optic nerve or leads to glaucoma in the eye. An artificial eye is fitted post-surgery to replace and match the original eye or the other eye with the good vision.
  • Exenteration Surgery- surgery to pull out the eye and eyelid, muscles, nerves, and fat in the eye socket. An artificial eye is measured and customized to resemble the other eye or a facial prosthesis.


Light coagulation, its other name, is an intraocular melanoma treatment that employs laser to produce a microscopic burn in the target tissue. The burn shrinks or eliminates abnormal growth of cells in the retina or deliberately cause scarring. The scarring is a result of breaking blood vessels that give nutrients to the tumor. Special lens will be positioned in your eyes while seated with your chin in a chin rest. The mirrors in the lens will guide doctors to direct the laser to the area of concern. With each pulse of the laser, you’ll see the light flashing before your eyes.


Heat is obviously used to shrink and kill the cancer cells in this cancer treatment. After the eye is numbed by local anesthesia, the heat raises the temperature of the tumor inside the eye. A laser is used to go through your dilated pupil and transmit the low-level heat to the cancer cells at the back of your eye. In order not to be too damaging to other parts of the eye, the increase in temperature is designed to be gradual. Thermotherapy is often used to treat small retinal and choroidal tumors. 

Clinical trials for new treatments

Aside from the standard treatment options, participating in a clinical trial is also a treatment choice. You get treated and studied to fill in the gaps of previous research conducted or test medical advancements if they are safe and effective, optimal to standard treatment, or at least complementary to it.

Clinical trials are not an isolated kind of treatment for in fact, standard treatments are by-products of previous clinical trials. Patients can even receive the best of both worlds or be among the first test subjects for a new treatment.

Clinical trials don’t provide all the answers even if it incorporates both conventional, alternative, and new treatments but in this specific account for treating intraocular melanoma, we move inch by inch closer to new solutions for dealing with eye cancer. 

Patients can take part in clinical trials at any stage of their cancer treatment.

In some clinical trials, only patients who have not yet been treated are included. This is to test if the new treatment or experiment is effective on its own without reinforcements. Other trials examine treatments for patients whose cancer has turned for the worse or has been in a neutral evolution, which means there are no growth or fitness changes during most of the lifetime of the cancer cells or tumor. In addition, there are clinical trials that examine new methods for preventing cancer from returning or reducing its side effects.

Follow-up tests may be needed.

Exams for intraocular melanoma or eye cancer diagnosis ,in general, are not a one-time thing. Each stage may be repeated, and depending on the location of the melanoma, the status of the treatment would have to be assessed, so repeated tests may be necessary. 

The results of these follow-up tests also help the patient decide whether to continue, change, or stop treatment.

Even if the treatment is completed, supplemental tests may be deemed optimal  or beneficial by the doctor in charge. This is to ensure further that the cancer isn’t coming back or, at the least,  not going to spread even more.

Early detection and proper treatment are key

If you think you have intraocular melanoma based on googling signs and symptoms, it’s all the more a smart move to schedule an appointment with your doctor right away. Arizona Retinal Specialists is an association of medical professionals that promote overall well-being and quality of life. Their expertise includes tackling not just the symptoms of intraocular melanoma but also its underlying causes from other anatomical conditions of a person. Schedule an appointment with us today.


NOTICE TO USERS is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified health provider with any questions you may have regarding any health symptom or medical condition. Never disregard professional medical advice nor delay in seeking professional advice or treatment because of something you have read on