[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Conditions](https://durgical.com/en/conditions/) › Uveal melanoma

# Uveal melanoma

The most common primary eye cancer in adults, usually in the [choroid](https://durgical.com/en/anatomy/choroid/). Often found on a routine exam; it can spread to the liver.

Updated Nov 12, 2026

On this page

- The basics What it is
- Who gets it
- Causes
- Risk factors
- Pathophysiology
- In ophthalmology

- Clinical Symptoms and signs
- Red flags
- Diagnosis
- Differential diagnosis
- Complications
- Prognosis

- Treatment Goal of treatment
- Treatment
- Prevention

- Study Test yourself

- Connections Connections

## What it is

A malignant tumour of the melanocytes of the uvea, most often in the choroid, less often in the [ciliary body](https://durgical.com/en/anatomy/ciliary-body/) or [iris](https://durgical.com/en/anatomy/iris/). It is the most common primary intraocular cancer in adults. Many are found on a routine fundus exam; others cause blurred vision, floaters or field loss from an associated retinal detachment. Its main threat is liver metastasis, which can appear years later.

See it in 3D

- [Choroid](https://durgical.com/en/anatomy/choroid/)
- [Iris](https://durgical.com/en/anatomy/iris/)
- [Ciliary body](https://durgical.com/en/anatomy/ciliary-body/)
- [Retina](https://durgical.com/en/anatomy/retina/)

## Who gets it

Usually after 50; much more common in fair-skinned people of European ancestry and rare in people with darker [skin](https://durgical.com/en/anatomy/skin/).

## Causes

- Malignant transformation of uveal melanocytes, sometimes from a pre-existing naevus
- Mutations such as GNAQ, GNA11 and BAP1

## Risk factors

- Fair skin and light iris colour
- Ocular melanocytosis
- Choroidal naevus with high-risk features
- BAP1 tumour predisposition syndrome

## Pathophysiology

The tumour grows from the choroid, often breaking through Bruch membrane into a mushroom shape, and causes serous retinal detachment. It spreads by blood, mainly to the liver.

## Symptoms and signs

- Often none
- Blurred vision, floaters or flashes
- A shadow in the visual field
- A dark spot on the iris that grows

## Red flags

- A pigmented fundus lesion with thickness, orange pigment, subretinal fluid or symptoms
- Growth of a known naevus
- Sentinel dilated episcleral vessels over a ciliary body mass

## Diagnosis

**Clinical**
Dilated fundus examination by ophthalmology; most diagnoses are clinical, without biopsy.

**Tests**
[Liver](https://durgical.com/en/anatomy/liver/) function tests and systemic staging; tumour biopsy for genetic prognosis in selected cases.

**Imaging**
Ocular ultrasound (low internal reflectivity, mushroom shape), OCT and autofluorescence; liver imaging for staging and follow-up.

## Differential diagnosis

- Choroidal naevus
- Choroidal metastasis
- Choroidal haemangioma
- Peripheral exudative haemorrhagic chorioretinopathy

## Goal of treatment

Control the tumour, preserve the eye and vision when possible, and watch for metastasis.

## Treatment

**Procedure**
Plaque brachytherapy or proton beam radiotherapy for most small and medium tumours.

**Surgical**
Enucleation for large tumours or a blind, painful eye; local resection in selected cases.

**Follow-up**
Lifelong liver surveillance; systemic treatment by oncology for metastasis.

## Complications

- Retinal detachment
- Radiation retinopathy and optic neuropathy after treatment
- Liver metastasis

## Prognosis

Local control is good, but metastasis occurs in a substantial share of patients, with risk linked to tumour size and genetics.

## Prevention

- Regular examination of choroidal naevi with risk features

## Test yourself

Think of the answer, then tap the question to see it.

## What is the most common primary intraocular cancer in adults?

Uveal melanoma.

## Where does it most often metastasise?

To the liver.

## How are most small and medium tumours treated?

With plaque brachytherapy or proton beam radiotherapy.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/conditions/uveal-melanoma/)

## In ophthalmology

- [Enucleation, evisceration and the artificial eye](https://durgical.com/en/ophthalmology/enucleation-evisceration-and-the-artificial-eye/)

## Connections

## Related conditions 3

- [Melanoma](https://durgical.com/en/conditions/melanoma/)
- [Retinal detachment](https://durgical.com/en/conditions/retinal-detachment/)
- [Retinoblastoma](https://durgical.com/en/conditions/retinoblastoma/)

Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Ocular Melanoma](https://www.ncbi.nlm.nih.gov/books/NBK551647/) (StatPearls Publishing (NCBI Bookshelf), 2024).

[← All conditions](https://durgical.com/en/conditions/)

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/conditions/uveal-melanoma/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/conditions/uveal-melanoma/