Most people are familiar with freckles on the skin, but different freckles may occur on multiple parts of the eye. An eye freckle is similar to a mole on the skin, and it can either be yellow, gray, or brown. Some people even have iris freckles, which is also not that unusual. Although it is usually harmless, seeking professional medical care is essential since eye freckles have a slim chance of developing into a type of eye cancer called ocular melanoma.
Eye freckles often result from sun exposure, mainly for people with a light complexion and light-colored eyes. Babies can be born with conjunctival nevi, an eye freckle found on the eye’s surface, while some people may develop the condition during childhood. Typically, freckles appear as brown spots on the conjunctiva, the outer white surface of the eye, brown or dark spots on the blue iris, or the inside wall of the eye.
What Does Having Eye Freckles Mean?
Most freckles are benign, harmless, and unlikely to cause severe medical conditions but have a small chance of becoming cancerous. However, having eye freckles may signify that the person is at a higher risk of developing sun-related eye problems such as cataracts and macular degeneration. Therefore, it is essential to have an annual eye checkup to prevent such complications.
Cataract often develops when the eye’s lens becomes cloudy, resulting in blurry or decreased vision. The condition usually occurs due to age, but the sun’s UV light can be absorbed by the lens and cause damage over time, contributing to the progression of cataract development. While sunlight alone cannot cause cataracts, UV light is the leading factor that increases the danger of cataract progression or development.
How Freckles Develop on The Eye
Eye freckles and moles usually develop when melanin-producing cells clump or cluster together. These cells are referred to as melanocytes and are responsible for the pigment that gives color to the eyes, skin, and hair. Although people can be born with it, eye freckles have no health issues but are more likely to develop into cancer.
With varying causes of eye freckles, race and sun exposure are some leading factors contributing to eye freckle development for some people. In addition, some common conditions may cause eye freckles, including:
- Conjunctival nevus: A pigment lesion on the conjunctiva or the white part of the eye usually appears in childhood, accounting for over half of conjunctival lesions.
- Iris nevus: A freckle found on the iris or the colored part of the eye and often appears in about 60% of people and develops due to excessive sun exposure.
- Choroidal nevus: It is a freckle in the back of the eye with a flat pigmented lesion that is benign but noncancerous. However, choroidal nevi have a small potential of becoming cancerous, thus essential to seek medical care.
In most cases, people with conjunctival nevi have a visible freckle on the white part of the eye, but the color may change during puberty or pregnancy. Iris nevi can be difficult to see, but they can be detected through an eye exam or in individuals with blue eyes. Unlike conjunctival and iris nevi, choroidal nevus are asymptomatic, meaning they are only detected during a routine fundoscopic exam.
Signs Your Eye Freckles May Be Cancerous
Eye freckles that may develop into ocular melanoma do not cause any early symptoms, but a nevi might be cancerous if it has the following signs:
- A visible brown spot or freckles that increase in size over time
- Eye discomfort or or other vision problems, such as seeing “flashing lights.”
- A choroidal nevus measuring more than two millimeters in thickness
- An orange choroidal nevus
- Blurred vision
Determining if an eye freckle is abnormal can be difficult, especially when the lesion is small, hard to see, and inside the eye. Therefore, it is essential to have an annual eye health exam to determine if your eye freckle might be cancerous or abnormal. An eye doctor can also evaluate if your eye freckle requires medical treatment.
Eye Freckle Diagnosis
Eye freckles have no significant symptoms to detect their occurrence, but they can only be detected through routine eye tests. Eye doctors use imaging technology such as Optical Coherence Tomography (OCT) to evaluate the eyes, mainly in the case of choroidal nevus. Photography can also help detect eye freckles more precisely, particularly when comparing changes in size and shape over time.
Visiting an optician every six months and undergoing an eye freckle diagnosis can help determine if your nevus is abnormal or likely to develop into melanoma. If there is no change in the freckle for one or two years, the risk of developing cancerous cells is minimal. However, an eye freckle might change into cancerous as you age, hence the need to see an eye doctor regularly.
Can Eye Freckles Affect Vision?
Typically, eye freckles involve harmless benign marks that form on different eye parts when melanin-producing cells clump together. Even though the nevus is visible in the eye, it does not affect an individual’s vision. However, cancerous nevi has a higher chance of affecting a person’s vision if it grows in size.
A person with cancerous freckles can experience changes in vision associated with these tumors, mainly distorted or blurry sight, a decrease in the visual field, and seeing floaters. In such cases, an eye doctor will recommend eye treatment if the condition develops into melanoma. Scheduling an eye exam if you notice irregularities or changes in vision is essential to help manage the problems earlier.
Can Eye Freckles Cause Complications?
Most eye freckles are noncancerous and have no health issues, but they can still develop into eye melanoma. Consulting an eye doctor can help monitor your freckles and determine if they pose any complications. Besides, an eye doctor can notice any changes earlier and begin the treatment process before it becomes a serious medical condition.
Close observation of eye freckles helps detect any potential cancerous changes, including possible metastasis early. Therefore, it is advisable to visit a doctor to examine the nevus at least once a year, noting the shape, size, and if there is any elevation. Although rare, some lesions may cause other conditions, such as congenital hypertrophy of the retinal pigment epithelium (CHRPE).
Do Eye Freckles Need Treatment?
Eye freckles do not require treatment, like moles and freckles on the skin. Because they have a small chance of developing into cancer or affecting vision, most people can live with the nevi in their eyes. However, an eye doctor may recommend eye freckle treatment if the nevus might be a melanoma. The freckle will then be monitored to document color, size, and shape changes through regular exams.
If complications occur and the nevus needs to be removed, it can be done through radiation therapy or surgery. Typically, eye freckles removal surgery involves a local excision using a small blade and argon laser photoablation. But since eye freckles have no health problems, they do not need to be removed as they could result in more damage to the eye.
When To Seek Medical Care If You Have Eye Freckles
Most people with eye freckles live a healthy and normal life without complications, although it is advisable to have a regular eye check exam with a doctor. However, if the nevus is abnormal or cancerous, you may require treatment to prevent the nevus from causing other complications. Always call your healthcare provider immediately if:
- The nevus changes shape or color
- You feel pain in the eye caused by the nevi
- You experience problems with your vision
- You develop a new spot on the eye
Should You Be Worried If You Have Eye Freckles?
Generally, eye freckles do not signify or pose any health risks, and the nevi can go unnoticed. However, an eye freckle has a slight chance of suggesting a sign of a serious medical condition, mainly ocular melanoma. This type of cancer develops within the cells that cluster or form a nevus in the eye.
Ocular melanoma is a common form of eye cancer, but people are rarely diagnosed with the condition. When determining if an eye freckle is a cause of concern or not, an eye doctor will establish how the nevus formed and its location in the eye.
While people born with eye freckles have a small chance of developing cancerous cells, nevi that form later in life have a greater risk of having ocular melanoma. In addition, individuals with choroidal nevi have a higher risk of developing ocular melanoma than those with iris nevi or conjunctival nevi.
If you have eye freckles, it is essential to schedule a routine eye exam with an eye doctor to evaluate your nevus for iris melanoma or other kinds of eye disease. An eye doctor can help determine if your eye freckles have a chance of developing into cancerous cells or causing other medical conditions. With proper medical care, you do not have to worry about nevus in your eyes, and help you achieve better eye health.
Aside from eye freckles, can watery eyes be a symptom of cancer? At Immunity Therapy Center, we can help you get more insights into eye freckles, including practical ways to treat them and live a healthy life. For more information, contact us to find out more about eye freckles today.
Written By: Dr. David Alvarez
Dr. David Alvarez is a Board Certified Medical Doctor from Universidad Xochicalco and Certified by the American Heart Association (Advanced Cardiovascular Life Support).
Dr. Alvarez has been collaborating with Dr. Bautista as an Assistant Medical Director at the Immunity Therapy Center for over 6 years. He provides daily on site patient care and participates on the medical board on research and development of patient treatment plans and programs. Dr. Alvarez is a knowledgeable and compassionate Doctor committed to helping patients get to where they want to be health wise through a more holistic and comprehensive approach.
At Immunity Therapy Center, our goal is to provide objective, updated, and research-based information on all health-related topics. This article is based on scientific research and/or other scientific articles. All information has been fact-checked and reviewed by Dr. Carlos Bautista, a Board Certified Medical Doctor at Immunity Therapy Center. All information published on the site must undergo an extensive review process to ensure accuracy. This article contains trusted sources with all references hyperlinked for the reader's visibility.