You might look at the mirror one day and notice a small freckle forming in your eye. Is an eye freckle serious? Most of us associate freckles and moles with the skin, but it’s pretty rare for one to develop on the eye.
But is an eye freckle something you should worry about? Well, the answer depends on the type of eye freckles you have.
In some cases, an eye freckle is harmless, just like many moles or birthmarks on the skin. However, some eye freckles can be serious. Let’s take a look at some of the different types of eye freckles and what they could mean.
Freckles on the Iris
An eye freckle will sometimes form on the iris, which is the colored area of your eye. In many cases, this is what is known as iris ephelis, a freckle caused by an increase in the amount of a pigment known as melanin. It won’t cause a loss of vision or any other problems.1
Other times, however, an eye freckle can be what is known as an iris nevus. This is a relatively rare dark spot that is usually larger than an iris ephelis, and it grows larger as time goes by. Only about 4 to 6 percent of adults have iris nevi.
Iris nevi are also harmless – most of the time. But they can grow very large in rare cases, leading to eye issues that can result in a loss of vision for some individuals.2
Another type of nevus, known as a conjunctival nevus, forms on the film that protects the white portion of your eye (the conjunctiva). Some people develop freckles or moles on this part of the eye.
Conjunctival nevi can appear as pigmented lesions that are yellow or brown. They can become lighter or darker over time. They’re usually harmless, but your eye doctor will want to check them to make sure they don’t turn into something serious.3
What Does Choroidal Nevus Mean?
While you can see most types of eye freckles, there are some that can only be discovered when an ophthalmologist performs an examination. One example is what is known as a choroidal nevus, which is an eye freckle that develops in the back portion of the eye.
Now, a choroidal nevus develops in the choroid, a layer of tissues and blood vessels located under the retina. It can be one of several colors, including brown, yellow, or gray. If it’s orange, that could be a sign of a potentially serious problem.4
A choroidal nevus is a form of intraocular tumor. And while it would obviously be scary to hear you have a tumor growing on your eye, a choroidal nevus is typically benign.
It can, however, lead to lesions or blood vessel abnormalities that could threaten your eye health.5
Choroidal Nevus and Retinal Detachment
Now, there are some cases where a choroidal nevus can start to leak. This can lead to something called a retinal detachment.6
When this occurs, the retina becomes separated from the tissue that supports it. For some individuals, the result can be a loss of vision. The main job of the retina is to transmit visual images to the brain via the optic nerve.
Symptoms of a retinal detachment include seeing spots or flashes of light. Surgery is sometimes needed in order to address the issue so a patient can once again see normally.7
When to See a Doctor if You Have an Eye Freckle
Even though eye freckles are typically harmless, you should always see your eye doctor when you spot one. This is especially the case if you’re experiencing any odd symptoms, like:
- Seeing flashing lights
- Pain in the eye
- Vision changes
- Changes in the color, shape, or size of the freckle8
Your doctor will perform a thorough eye examination, looking closely at the retina, iris, blood vessels, optic nerve, and all other areas of the eye. You’ll be asked about symptoms you’re having. Your eye doctor can make a diagnosis and recommend treatment.
How are Freckles in the Eye Treated?
Again, an eye freckle is harmless most of the time. There are, however, some cases where freckles or moles can signify something’s wrong. When that’s the diagnosis, treatment is needed to minimize the risk to your eye health.
If an eye freckle proves to be troublesome, surgery may be needed. Here are a few of the more common procedures.
This procedure removes portions of the iris where dangerous cells may be forming so that they can’t spread to other areas of the eye. Clinical trials are underway to determine the safety of a similar procedure called a peripheral iridotomy, which involves the use of a laser.9
This surgery involves removing a part of the iris, as well as a part of the eye called the ciliary body. This area between the retina and the white portion of the eye consists of a thin layer of tissue and blood vessels.10
A choroidectomy involves removal of a portion of the choroid. It sometimes also involves radiation therapy.11
If a tumor associated with a nevus gets too large, and other treatment options would lead to the loss of most of the eye, enucleation is typically performed. This is where the entire eye is removed and replaced by a prosthesis.12
Other Treatment Options
Surgery can be avoided in many cases. In one type of therapy, for example, external beam radiation is often used to target harmful cells while protecting nearby cells that are healthy.13Laser therapy uses an external beam of heat to attack any potentially dangerous tumor growth.14
How Does Exposure to UV Light Cause Freckles?
Many factors can contribute to the development of an eye freckle. Just like UV light from the sun can increase your risk of skin damage, exposure to sunlight can also increase your risk of eye damage.
According to one study, these factors include age, eye color, and previous sunburns. Researchers found that freckles typically develop in the lower portion of the iris. Sun exposure, study researchers say, could lead to macular degeneration, a disease that can lead to blindness.
They believe this happens because this area of the eye doesn’t get a lot of protection from UV (ultraviolet) light in the form of shade created by the eyebrows or the nose. According to the researchers conducting the study, iris freckles are an indication of UV light exposure.15
Don’t Panic, But Take Action
Just as you should see a dermatologist if you see dark spots on your skin due to a mole or freckle, you need to visit an eye doctor if you see a freckle on your eye.
Even if the initial diagnosis is that there’s nothing wrong, your doctor will probably want to monitor the situation to be sure.
Your eye doctor can also give you advice on how to reduce some of the risk factors that could lead to future eye issues. After all, your eyes are precious, and by taking good care of them, you’ll be able to maintain good vision for years to come.
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