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Melanoma is a type of cancer that originates within the cells that form pigment or melanin. These cells are called melanocytes and can be found throughout the body. While melanoma is most commonly found on the skin, it can also occur inside the eye as well as on the surface. The pigmented areas of eye such as the choroid and iris are most commonly affected; however, melanoma sometimes occurs on the conjunctiva as well.
There appears to be a strong association with the development of melanoma and exposure to ultraviolet light. People at particular risk for developing melanoma are those who sunburn easily, have fair skin, light hair and eyes. Most people with melanoma have had excessive exposure to the sun or ultraviolet light at some point in their lives.
Deep in the epidermis are cells called melanocytes. Melanocytes make melanin, which gives colour to your skin. When skin is exposed to the sun, the melanocytes make more melanin and cause the skin to tan or darken. Sometimes melanocytes cluster together and form moles (called nevi). Moles are common and are usually not cancerous.
Conjunctival malignant melanoma is a rare malignancy of the conjunctiva, the eye's outermost covering. Most conjunctival malignant melanomas arise from a condition called primary acquired melanosis (pigmentation). The malignancy may also arise from a freckle or nevus on the conjunctiva, or even healthy tissue. A conjunctival melanoma cannot be diagnosed with an eye examination. Any brown, speckled, pigmented area that changes over time is suspicious. A definitive diagnosis can only be made after surgical excision of suspicious lesions. The melanoma is usually removed using a "no-touch" technique, followed by freezing (cryotherapy) of the surgical margins. Good vision in the affected eye is often preserved.
Like melanoma of the skin, conjunctival malignant melanoma may metastasize to the another area of the body. If this occurs, the patient's survival depends on the origin of the tumor, i.e. whether the tumor arose from primary acquired melanosis, a conjunctival nevus, or healthy tissue. In many cases, this cannot be determined. The prognosis is often good but those diagnosed with conjunctival melanoma must have a systemic evaluation and routine follow-up evaluations.
