Ocular (eye) melanoma

Ophthalmoscopy (funduscopy)

This is a test that allows your doctor to look at the inside of your eye to check for abnormalities. You may be asked to look into a large microscope that sits on a table. The doctor may put drops in your eye to widen (dilate) your pupil, allowing the doctor to look inside the eye so that they don’t need to perform a biopsy.

Colour fundus photography

In this procedure photographs of the back of your eye (fundus) will be taken and can help show what the tumour looks like before and after treatment. You will have eye drops to dilate your pupil.

Ultrasound

An ultrasound uses soundwaves to create pictures of the inside of your eye and surrounding areas. A gel will be spread over your closed eyelid and a small device called a transducer will be moved over the area. The transducer sends out soundwaves that echo when they come across something dense, like a tumour or an organ.

Transillumination

If you need surgery, this test will be done first to show where the melanoma is. The lights in the room will be turned down and your doctor will shine a very bright light into your eye to check for abnormal areas.

CT scan

Special machines are used to scan and create pictures of the inside of your body. You may have an injection of dye into your veins before the scan which makes the pictures clearer. During the scan you will lie on a table which moves in and out of the scanner. A CT scan takes about 10-30 minutes.

MRI

An MRI scan produces detailed cross-sectional pictures of your body and can show the extent of any tumours. You will lie on a table which slides into a large metal tube that is open at both ends. An MRI scan takes about 30-90 minutes.

Biopsy

In most cases, the ophthalmologist can make a diagnosis from what they can see when they examine your eye from photographs and ultrasound images. However, sometimes a biopsy is needed where some tissue is removed from the affected area to be examined under a microscope.

Surgery

Surgery for ocular melanoma may involve removing just the tumour, removing part of the eye, or removing the entire eye (enucleation) if it has been severely damaged by the tumour.

Radiation therapy (radiotherapy)

Radiation therapy (also known as radiotherapy) uses high energy rays to destroy cancer cells. It may be used for ocular melanoma:

• after surgery, to destroy any remaining cancer cells and stop the cancer coming back
• if the cancer can’t be removed with surgery
• instead of removing the eye (enucleation)
• if the cancer has spread to other parts of the body (e.g. palliative radiation to control symptoms or to manage pain).

Laser treatment (transpupillary thermotherapy) or photodynamic therapy

This treatment uses an infrared laser to heat and destroy cancer cells. It is sometimes combined with photodynamic therapy which uses a laser combined with a light-sensitive drug to destroy cancer cells.

Immunotherapy

Immunotherapy uses drugs to stimulate your own immune system to recognise and attack cancer cells. It has been very helpful in treating skin melanoma and has now shown benefit in treating ocular melanoma.

Palliative care

In some cases of advanced cancer, treatment will focus on managing any symptoms, such as pain, and improving your quality of life without trying to cure the disease. This is called palliative treatment.

Palliative care can be provided in the home, in a hospital, in a palliative care unit or hospice, or in a residential aged care facility. Services vary because palliative care is different in each state and territory.