Diagnosis
If you have any signs or symptoms of melanoma of the eye, see an ophthalmologist as soon as possible. Optometrists commonly handle normal vision problems such as glaucoma, and can prescribe glasses and contact lenses. An ophthalmologist is a medical doctor (M.D.) who can do this, and can also diagnose more complex diseases of the eye and perform eye surgery. A professional eye exam by an ophthalmologist with specialist training in eye cancer is usually needed to diagnose melanoma of the eye. The ophthalmologist may perform any of the following procedures to diagnose uveal melanoma:
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Dilated retinal exam/Slit-lamp biomicroscopy
The doctor will give the patient medicated eye drops to dilate (enlarge) the pupil, allowing the doctor to see through the lens and pupil to the retina. The doctor will then examine the inside of the eye using a slit-lamp, which is a low-power microscope that produces a powerful, narrow beam of light. The doctor may also attach a camera to the slit-lamp to take pictures over time and monitor tumor growth.
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Indirect ophthalmoscopy
The doctor will give the patient medicated eyedrops to dilate (enlarge) the pupil, allowing him or her to see through the lens and pupil to the retina. The doctor will shine a very bright light into your eye from a headlamp and use a small handheld magnifying lens to examine the back of your eye.
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Ultrasound of the Eye
A doctor will first numb your eye with special eye drops and position an ultrasound probe on the surface. This probe bounces sound waves off of structures inside the eye. The echoes are then registered by the probe to produce a picture of the inside of the eye. The doctor may also recommend an ultrasound biomicroscopy (UBM) to diagnose melanoma of the iris. An ultrasound biomicroscopy produces higher-resolution pictures of the front (anterior) of the eye using higher-frequency sound waves than a normal ultrasound.
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Fluorescein angiography
Doctors use this procedure to examine blood flow inside the eye. Orange dye is injected into the patient's arm. A camera then takes pictures as the dye moves through blood vessels in the choroid and retina. The doctor will then examine these images and check for any blood flow abnormalities, such as a leakage or blockage in the blood vessels.
Surgical biopsy
A surgical biopsy usually is not needed to diagnose this disease. However, in the past few years, some doctors have advocated using surgical biopsies to determine the prognosis of the disease. The doctor uses a thin, hollow needle to extract a tissue sample from the eye. This tissue is assessed in a laboratory and the melanoma is classified as having a high or low risk of spreading, based on whether the melanoma cells express certain genes.
