Ocular melanoma risk increases as UV levels reach seasonal highs

The Australian Society of Ophthalmologists (ASO) is urging Australians to wear sunglasses as UV levels reach seasonal highs, increasing the risk of ocular melanoma.

Sun protection measures are recommended when the Ultraviolet (UV) Index is 3 and above, but most of mainland Australia is currently experiencing seasonal indexes within the ‘extreme’ range of 11–15.

ASO vice president Associate Professor Dr Ashish Agar said it comes as no surprise that Australia has some of the highest UV ratings in the world.

“It’s an Australian childhood rite of passage to learn to ‘Slip, Slop, Slap, Seek and Slide’, especially when the call of summer arrives,” Agar said.

“A very important part of the message often gets overlooked, and that concerns our eye health.”

Fellow ophthalmologist Dr Bill Glasson said Australians should be wary of not only developing melanoma on their skin this summer, but the risks associated with ocular melanoma — the most common form of eye cancer.

“Each year 125–150 people will be diagnosed with ocular melanoma around the country. As the symptoms and common areas for growths can be difficult for the naked eye to see, patients often receive a diagnosis following an eye test with either an ophthalmologist or optometrist,” Glasson said.

This was the case when then 37-year-old mother of two, Ms Susan Vine, booked in to see an optometrist for an assessment for glasses after experiencing frequent headaches.

Vine was immediately referred to Glasson, who has a special interest and expertise in ocular oncology.

Within two weeks of an initial eye test, she had been diagnosed with a form of ocular melanoma and had undergone enucleation surgery — the complete removal of her affected eye.

Seventeen years on from her diagnosis, Vine has become an advocate for others by establishing an online support group for Australian and New Zealand patients, family, and carers — OcuMel Australia and New Zealand.

“The journey and challenges are unique, especially when it comes to treatment and related vision loss, so we find many of our members are looking for understanding, guidance and support,” she said.

Vine said there is an alarming lack of awareness about eye health and wants every Australian to know to ‘slide’ on their sunglasses and make a healthy habit of booking an annual eye test.

“Every day I live with the reminder of my diagnosis and the challenges that come with being vision impaired and wearing a prosthetic eye, such as thinking about how I sit or even cross the road.

“I rarely wore sunglasses when outdoors, and despite having a freckle on my eye from childhood, did not realise the importance of monitoring it for changes. We need to teach children the value of protecting their eyes from a young age and encourage healthy habits early of getting regular health checks,” she said.

In addition to ocular melanoma, skin cancers such as basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) can be found in and around the eyes, strengthening the cause to protect not only eyes, but the areas around them.

The ASO said risk factors to be aware of include having pale or fair complexion, light eye colour, family history of melanoma, growths on or in the eye, increasing age, and skin conditions which cause abnormal moles to grow.

It also noted that individuals with pterygium are at a greater risk of developing skin cancer, including melanoma, as the condition is a marker for previous exposure to high levels of UV light.

Agar said the best method of eye health protection from the effects of UV exposure is to ‘slide’ on UV-blocking eyewear this summer and ‘slap’ on broad-brimmed headwear.

“Always check the label when buying eyewear to confirm the level of UV protection,” he said.

“At the ASO, we recommend wearing close-fitting and wraparound style sunglasses that meet the Australian and New Zealand Standard for sunglasses with a lens category of 2, 3 or 4 — which will ensure they’re practical for wear in Australian conditions.

“And don’t forget — for best practice when selecting headwear — a broad-brimmed hat will provide the optimum eye protection against reflected radiated rays.”