Ocular melanoma treatment options depend on the location and size of the eye melanoma, as well as several other factors including:
- Age of the patient
- General health
- State of the unaffected eye
- Vision potential of the unaffected eye
Ocular melanoma is generally defiant to general therapies, so early diagnosis and treatment is essential. If the tumor spreads it can be more difficult to treat. The main goals of treating eye melanoma include preventing growth of the tumor, saving the eye and returning the vision back to normal.
Operations to treat ocular melanomas may include removing part of the eye or removing the entire eye.
Surgery to remove the tumor and a small part of the healthy tissues around it are considered a safe option for the treatment of small tumors. The type of surgery needed depends on the location and size of the melanoma. For example, operations involving removal of a small melanoma affecting the iris of the eye is called iridectomy, while removing a melanoma from the choroid is called choroidectomy.
Surgeries removing the entire eyes are called enucleation and are most often used for larger tumors. After the affected eye is removed an artificial eye is inserted into the same position with muscles controlling the movements of the eye attached to it.
For small and medium size tumors, radiation is the preferred treatment, although there are no studies to show which form of radiation is the best and most effective. Radiation therapy uses energy beams, such as protons or gamma rays, to kill melanoma cells. Radiation therapy is generally used for small to medium-sized eye melanomas.
Three types of radiotherapies are used to treat eye melanomas:
- Plaque Radiotherapy
- Proton Beam Radiotherapy
- Stereotactic Radiotherapy
Plaque Radiotherapy is most commonly used to treat medium or small sized melanomas. It is a lengthy treatment and the patient may have to stay at the hospital for a long period of time. However, in some states patients are allowed to go home between treatments.
Proton Beam Radiotherapy is a treatment where a beam of protons (charged particle) is fired at the tumor. This therapy requires a minor surgery where tantalum rings are placed around the tumor, so that that radiation beams can be focused.
Stereotactic Radiotherapy is used to treat the tumor with a dose of radiation in smaller fractions.
Laser treatments to kill the ocular melanoma cells may be used in particular situations. Thermotherapy is a kind of laser treatment that uses infrared lasers and is sometimes combined with radiation therapies to enhance the effectiveness.