Eye exam: Your doctor will examine the outside of your eye, looking for enlarged blood vessels that can indicate a tumor inside your eye. Then, with the help of instruments, your doctor will look inside your eye. One method, called binocular indirect ophthalmoscopy, uses lenses and a bright light mounted on your doctor's forehead-a bit like a miner's lamp. Another method, called slit-lamp bio microscopy, uses lenses and a microscope that produces an intense beam of light to illuminate the interior of your eye.

Eye ultrasound: An eye ultrasound uses high-frequency sound waves from a hand-held, wandlike apparatus called a transducer to produce images of your eye. The transducer is placed on your closed eyelid or on the front surface of your eye.

Imaging of the blood vessels in and around the tumor (angiogram): During an angiogram of your eye, a colored dye is injected into a vein in your arm. The dye travels to the blood vessels in your eye.

A camera with special filters to detect the dye takes flash pictures every few seconds for several minutes.

Optical coherence tomography: The imaging test creates pictures of portions of the uveal tract and retina.

Removing a sample of suspicious tissue for testing: In some cases, your doctor may recommend a procedure to remove a sample of tissue (biopsy) from your eye.

To remove the sample, a thin needle is inserted into your eye and used to extract suspicious tissue. The tissue is tested in a laboratory to determine whether it contains eye melanoma cells.

An eye biopsy isn't usually necessary to diagnose eye melanoma.

Treatment

Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your overall health and your preferences.

Waiting to treat small eye melanomas

A small eye melanoma may not require immediate treatment. If the melanoma is small and isn't growing, you and your doctor may choose to wait and watch for signs of growth.

If the melanoma grows or causes complications, you may choose to undergo treatment at that time.

Radiation therapy

Radiation therapy uses high-powered energy, such as protons or gamma rays, to kill cancer cells. Radiation therapy is typically used for small to medium-sized eye melanomas.

The radiation is usually delivered to the tumor by placing a radioactive plaque on your eye, directly over the tumor in a procedure called brachytherapy. The plaque is held in place with temporary stitches. The plaque looks similar to a bottle cap and contains several radioactive seeds. The plaque remains in place for four to five days before it's removed.

The radiation can also come from a machine that directs radiation, such as proton beams, to your eye (external beam radiation, or teletherapy). This type of radiation therapy is often administered over several days.

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