Tests for eye cancer (ocular melanoma)

If you have symptoms of eye cancer, you usually start by seeing your optician or GP. If they are unsure what the problem is, they will refer you to see a specialist at the hospital. A specialist eye doctor is called an ophthalmologist.

At the hospital, the ophthalmologist will examine you. The doctor may put eye drops in your eye before or during some tests. This widens (dilates) the black part in the middle of your eye (your pupil). This makes it easier to for the specialist to check your eyes. The drops make your eyesight blurry for a few hours, and you might find bright lights uncomfortable.

Do not drive until your eyesight returns to normal.

You may have some of the following tests.

The doctor looks at the inside of your eye using a small, handheld lens and light (ophthalmoscope). Or they may ask you to look into a large microscope that sits on a table. They may put eye drops in your eye to widen your pupil.

An ultrasound scan uses sound waves to build up a picture on a computer screen of the inside of your eye and nearby areas. The doctor gently presses a small probe against your closed eyelid and moves it over the skin. This is painless and usually only takes a few minutes.

The doctor uses this test to examine the back of your eye. They put eye drops in your eye to widen your pupil. They also inject a dye, called fluorescein, into a vein in your arm. The doctor uses a special camera to take photos of the dye as it moves through the blood vessels at the back of your eye.

You may feel warm or flushed for a short time after the injection. After the test, your urine will be bright yellow, and your skin may be slightly yellow. This is caused by the dye. It is harmless and only lasts a few days.

Doctors can often diagnose eye melanoma by looking inside the eye and using the tests we have explained above. But you may need to have a small piece of tissue or cells (biopsy) removed from the eye. You are more likely to have a biopsy if your specialist thinks you may have a conjunctival melanoma.

A biopsy is only done by expert eye doctors, who can do it quickly and without causing you pain. They use a very fine needle. You can have the test with a local anaesthetic, or sometimes with a general anaesthetic.

The tissue is sent to a laboratory to be looked at by a pathologist (a doctor who specialises in studying cells). The pathologist looks at the tissue under a microscope to check for cancer cells. They also check for conditions that may develop into melanoma if left untreated.