Eye Cancer – Eye Uveal Melanoma

Medically reviewed by: Prof. Dr. Fevzi Şentürk · Last updated: 7 September 2026

What is uveal melanoma?

Uveal melanoma is a malignant tumour arising from the pigment cells of the uvea — the choroid, ciliary body or iris. It is the most common primary intraocular cancer in adults. Early lesions frequently cause no symptoms and are found during a routine dilated examination.

Symptoms

• Blurred vision or a shadow in part of the visual field
• Flashes of light and floaters
• A dark spot on the iris that grows or changes shape
• Change in pupil shape or, in some cases, no symptoms at all

Diagnosis

Assessment includes dilated fundus examination, B-scan ultrasonography for tumour thickness and internal reflectivity, optical coherence tomography, fundus autofluorescence and, where indicated, angiography. Systemic staging with liver imaging is performed because the liver is the commonest site of metastasis. In selected cases a biopsy is taken for cytogenetic and gene-expression profiling, which informs prognosis and follow-up intensity.

Treatment

• Plaque brachytherapy: the most frequently used eye-preserving treatment for small and medium tumours
• Proton beam or stereotactic radiotherapy: selected tumour sizes and locations
• Transpupillary thermotherapy or local resection: in specific cases, usually combined with radiotherapy
• Enucleation: for large tumours or when the eye is painful and vision is lost
• Observation: for small suspicious lesions without documented growth, under close surveillance

Treatment is planned by an ocular oncology team and depends on tumour size and location, the state of the other eye and systemic findings. Long-term follow-up, including liver surveillance, continues after treatment.

Important: any newly noticed pigmented lesion in the eye, a growing dark spot on the iris, or a persistent shadow in the field of vision should be assessed without delay.

Frequently asked questions

Does uveal melanoma cause symptoms early?

Often not. Many tumours are found during a routine dilated eye examination.

Can the eye be preserved?

In many small and medium tumours, plaque brachytherapy or radiotherapy allows the eye to be preserved.

Why is the liver checked?

The liver is the commonest site of metastasis, so imaging is part of staging and long-term follow-up.

Is a biopsy always needed?

No. It is taken in selected cases for cytogenetic profiling, which informs prognosis and follow-up.

Medically reviewed by

Prof. Dr. Fevzi Şentürk — Professor of Ophthalmology — retinal diseases and vitreoretinal surgery, Nişantaşı Hastanesi Göz Merkezi. Our doctors

This page is for general information and does not replace an examination by a doctor. Treatment decisions are made after examination and diagnostic tests.