Yes, eyes can have freckles, medically termed nevi. These spots form due to clusters of melanocytes, cells producing melanin, the pigment that colors our skin, hair, and eyes. Similar to skin moles or freckles, eye freckles typically do not cause symptoms and are often harmless.
Where Eye Freckles Appear
Eye freckles can appear in different parts of the eye. Iris freckles are tiny, dark brown flecks found on the surface of the iris, the colored part of the eye. Iris nevi are similar but are larger and extend deeper into the iris tissue.
Another common type is the conjunctival nevus, which appears as a flat or slightly raised spot on the conjunctiva, the clear membrane covering the white part of the eyeball. Choroidal nevi are located at the back of the eye, beneath the retina in a tissue layer called the choroid. Unlike other types, choroidal nevi are not visible without a comprehensive eye examination.
What Causes Eye Freckles
Eye freckles form when melanocytes clump together instead of spreading out evenly. Some are present at birth, while others develop later.
Similar to skin freckles, sun exposure contributes to the formation of eye freckles. Increased ultraviolet (UV) light exposure may contribute to new iris nevi. Protecting eyes from UV light by wearing sunglasses is recommended to reduce the risk.
When to Be Concerned
While most eye freckles are benign, a small percentage can evolve into ocular melanoma, a type of eye cancer. Immediate medical attention is warranted for any noticeable increase in the freckle’s size or thickness. Changes in its shape or color, such as becoming darker or exhibiting multiple colors, are also concerning indicators.
New symptoms like changes in vision, including blurry vision or loss of peripheral vision, require an immediate eye examination. Seeing flashes of light, new eye floaters, or experiencing eye pain or discomfort are also signs of concern. For choroidal nevi, an ophthalmologist looks for an orange color, fluid leakage, or the development of abnormal blood vessels. These changes can sometimes lead to retinal detachment or vision loss.
Monitoring Eye Freckles
Regular monitoring by an ophthalmologist is essential for individuals with eye freckles. Ophthalmologists can identify nevi during routine comprehensive eye exams, even those not visible to the naked eye. They use specialized equipment, such as a slit lamp or ophthalmoscope, to examine the eye’s internal structures.
During these examinations, the ophthalmologist may take photographs of the nevus to document its size, shape, and color. These images serve as a baseline for future comparisons, allowing the doctor to track any changes over time. While self-awareness of any changes is helpful, only a medical professional can accurately assess the nature of an eye freckle and determine if further intervention is necessary.