Birthmarks can appear on the eye. A birthmark is a discoloration or mark on the skin that is present at birth or appears shortly after. Eye birthmarks are common and typically benign, meaning they usually do not affect vision or cause problems.
Understanding Eye Birthmarks
Eye birthmarks are commonly found on or around the eye. These marks can be present on the iris, the colored part of the eye, or on the conjunctiva, which is the clear tissue covering the white part of the eye. They can also appear on the retina at the back of the eye, or on the eyelids themselves. Most eye birthmarks form due to an overgrowth of pigment-producing cells called melanocytes or an abnormal collection of blood vessels. Many are discovered during a routine eye examination.
Most eye birthmarks do not pose a threat to vision or overall eye health. They are generally comparable to moles or freckles found on other parts of the body. While some eye birthmarks are present at birth, others can develop later in life. The vast majority remain stable over time and do not require intervention.
Common Types of Eye Birthmarks
Common types of birthmarks can appear on or around the eye.
Ocular Nevi: Often called eye freckles, these pigmented growths resemble moles. They include conjunctival nevi (yellowish to dark brown spots on the white of the eye) and iris nevi (small, dark brown flecks on the iris). Conjunctival nevi are common and typically harmless. Iris nevi are usually benign, but larger ones may be monitored. A choroidal nevus is located at the back of the eye, under the retina, visible only during a comprehensive eye exam.
Nevus of Ota: Characterized by blue or brownish pigmentation on the white of the eye (sclera) and often surrounding facial skin. This condition is caused by an increased number of melanocytes. While typically benign, Nevus of Ota is associated with a slightly elevated risk of developing glaucoma or, rarely, melanoma.
Hemangiomas: Vascular birthmarks, sometimes called “strawberry marks,” result from an abnormal collection of blood vessels. They can appear on or around the eyelids, often growing rapidly in the first few months of life before gradually shrinking and fading by age seven to ten.
Sturge-Weber Syndrome: A rarer condition where a port-wine stain birthmark on the face is accompanied by abnormal blood vessels in the brain and sometimes in the eye, potentially leading to increased eye pressure or glaucoma.
Potential Concerns and When to Seek Medical Advice
Certain signs and symptoms may indicate a need for medical attention. Any noticeable change in the birthmark’s size, shape, color, or elevation warrants an evaluation by an eye care specialist. For instance, a conjunctival nevus that grows larger or changes appearance should be assessed for potential malignant transformation, although the risk of this becoming cancerous is low, less than 1% over a lifetime.
Vision disturbances such as blurred vision, double vision, or a loss of vision can also be indicators of a concern. New pain, discomfort, itching, or irritation associated with the birthmark are also reasons to seek professional advice. Additionally, symptoms like redness, swelling, or discharge around the birthmark should be promptly investigated.
Certain types of eye birthmarks carry specific risks. For example, individuals with Nevus of Ota have an increased risk of developing glaucoma, a condition characterized by elevated pressure inside the eye that can damage the optic nerve. There is also a rare, though present, association between Nevus of Ota and the development of melanoma, a serious form of cancer. Regular eye examinations are important for anyone with an eye birthmark, even if it appears benign, to monitor for any changes over time.
Diagnosis and Treatment Approaches
If an eye birthmark causes concern, consult an ophthalmologist. They will conduct a comprehensive eye examination to assess its characteristics and location. Diagnostic tools, such as specialized imaging techniques, are often employed to monitor the birthmark or evaluate deeper structures of the eye. These can include fundus photography, which captures images of the back of the eye, optical coherence tomography (OCT) for detailed cross-sectional views, and ultrasound to measure the birthmark’s size and thickness.
For most benign eye birthmarks, the primary approach is regular monitoring through periodic follow-up appointments. If the birthmark affects vision, causes discomfort, or shows signs of potential malignancy, treatment may be considered. Treatment options are specific to the birthmark’s type and location, and may include laser therapy, surgical removal, or radiation. These interventions are rarely needed, with decisions based on a thorough evaluation by the ophthalmologist.