Moles can appear in the eye, where they are medically known as nevi. Similar to moles on the skin, eye nevi are common, pigmented growths that can be present from birth or develop later. While often harmless and causing no symptoms, some eye moles may require monitoring due to a small potential for change. Regular eye examinations are important to track any alterations and ensure eye health.
Locations of Eye Moles
Eye moles can appear in various parts of the eye, each with distinct characteristics. A conjunctival nevus manifests as a flat or slightly raised spot on the conjunctiva, the clear film covering the white part of the eyeball. These nevi often range in color from yellow to brown and are typically visible to the naked eye, sometimes changing in shade over time.
An iris nevus is found on the iris, the colored part of the eye. These usually appear as small, dark freckles and are generally benign. Iris nevi are generally visible, though an ophthalmologist can differentiate them from smaller iris freckles.
In contrast, a choroidal nevus is located deeper inside the eye, within the choroid layer beneath the retina. These nevi are not visible to the naked eye, requiring specialized ophthalmic equipment for detection during a comprehensive eye exam. They can appear gray, brown, or yellowish.
What to Look For
Visible eye moles, like conjunctival or iris nevi, appear as flat or slightly raised spots. Their coloration varies, often brown, black, yellow, or clear. Many individuals with these moles experience no symptoms, and their presence is frequently discovered during routine eye examinations.
A conjunctival nevus may have a clear, cystic component and can change in shading over time. Iris nevi, resembling small freckles, usually remain stable. Choroidal nevi are only detectable through professional examination using specialized tools.
Understanding Potential Risks
While most eye nevi are benign, a small percentage can rarely transform into a type of cancer called ocular melanoma. This transformation involves changes in the mole’s characteristics, similar to how skin moles can become melanoma. Recognizing specific warning signs is important for early detection.
For visible eye moles, the ABCDEF mnemonic, adapted from skin melanoma guidelines, helps identify potential concerns: Asymmetry; irregular Borders; Color variations; a Diameter larger than 6mm (though eye nevi can be smaller); Elevation; and Fluid leakage, especially for deeper nevi. Symptoms such as blurred vision, new floaters, flashing lights, or a loss of peripheral vision can suggest changes in a choroidal nevus. Fluid accumulation under the retina or the presence of orange pigment on the mole are also signs of concern for choroidal nevi. Factors including light eye color, fair skin, certain genetic predispositions, and ultraviolet light exposure may increase the risk of developing ocular melanoma.
Medical Evaluation and Care
Regular comprehensive eye examinations are essential, particularly if an eye mole is present or suspected. Ophthalmologists utilize various diagnostic tools to assess eye moles. For those on the surface, like conjunctival and iris nevi, a slit lamp examination allows for detailed viewing.
For choroidal nevi, specialized imaging techniques are necessary, including optical coherence tomography (OCT), ultrasound, and fluorescein angiography. These tools help ophthalmologists measure size, thickness, and detect subtle changes. Most benign nevi are monitored through periodic photography to track any alterations in size, shape, or color over time.
If an eye mole is determined to be malignant, treatment options for ocular melanoma may include radiation therapy, such as plaque brachytherapy, which involves placing a radioactive device on the eye. Laser therapy can also be used, especially for smaller tumors. In rare instances, surgical removal of the tumor or, in more severe cases, enucleation (removal of the entire eye) may be necessary.