Ocular nevi, commonly known as eye freckles, are common pigmented spots that can appear on or within the eye. Similar to freckles or moles on the skin, they represent a collection of melanin-producing cells. These spots are typically harmless and do not cause any symptoms or affect vision. For many individuals, understanding these pigmented areas is important as they are a normal part of eye anatomy.
Understanding Eye Freckles
Ocular nevi are benign pigmented lesions that are essentially clusters of melanocytes, the specialized cells responsible for producing melanin, the pigment that gives color to our skin, hair, and eyes. These freckles can manifest in various parts of the eye, varying in color from light brown to dark brown, yellow, or gray. They can also be flat or slightly elevated.
Iris Nevus
An iris nevus appears in the iris, the colored part of the eye. These can be small, flat spots on the surface or larger, deeper growths within the iris.
Choroidal Nevus
A choroidal nevus is located at the back of the eye, under the retina. These are not visible without a specialized eye examination.
Conjunctival Nevus
A conjunctival nevus is found on the conjunctiva, the clear film covering the white part of the eye and the inside of the eyelids. This type is often visible and can range in color from yellow to brown.
Causes and Risk Factors
Some ocular nevi may be present from birth, while others develop or become more noticeable over time, often appearing during childhood or adolescence. Genetic factors play a role in their formation. Individuals with lighter eye or skin color, particularly Caucasians, tend to be more prone to developing nevi.
Sun exposure is also a contributing factor, as ultraviolet (UV) light can stimulate melanin production. Wearing UV-protective sunglasses is recommended to help mitigate this risk.
Monitoring and When to Consult an Eye Doctor
While most eye freckles are benign, they require regular monitoring. In rare instances, they can change or indicate a more serious condition, such as ocular melanoma. An estimated 1 in 10 people have eye freckles; approximately 1 in 8 white individuals have an ocular nevus. The risk of a choroidal nevus transforming into melanoma is low, estimated at about 1 in 9000 per year, but increases with age.
Regular comprehensive eye exams are important for assessing and monitoring these lesions. An ophthalmologist can identify nevi during a routine examination and may use imaging technology, such as optical coherence tomography (OCT) or specialized photography, to document their size, shape, and appearance. These images allow the doctor to track any changes over time.
Certain signs or changes in an eye freckle should prompt an immediate consultation with an eye care professional. These include any noticeable changes in the nevus’s size, shape, color, or elevation. Other concerning symptoms are blurred vision, flashes of light, or new floaters, which can sometimes be associated with a choroidal nevus. A choroidal nevus is considered suspicious if it is thicker than 2 mm, has orange pigment, or shows subretinal fluid. Even if an eye freckle remains stable for years, continuous monitoring is recommended, as nevi can change over time.