Choroidal Nevus and Freckles in the Eye

Author: Premier Eye Associates

A choroidal nevus is an area in the back of the eye that has more pigment than the rest of the eye and looks like a freckle or mole. Similar to these skin findings, a choroidal nevus is rarely a problem and has very little risk for problems. However, there is a small risk with a choroidal nevus that it transforms into a more serious condition called choroidal melanoma. Since there is a small risk of this transformation, most eye doctors will elect to monitor the condition annually with a dilated eye exam and a photo of the nevus. If there are changes to the choroidal nevus, a referral to a retinal specialist is often needed to evaluate treatment options.


What is the Choroid?

The choroid is a part of the eye which is located in the back of the eye, behind the retina. The choroid has a dense blood supply and provides nutrients to the retina and other tissue in the eye.

Normally, the choroid is not pigmented and has no discernable color. There are many blood vessels in the choroid which are visible and allow an eye doctor to evaluate the choroid.

Any defect or problem with the choroid can greatly impact the retina as it is so close in proximity and relies upon the choroid for blood supply.


How is a Choroidal Nevus Diagnosed?

A choroidal nevus can be diagnosed by an eye doctor using a technique to view the retina and the choroid. This can include a dilated eye exam, a slit lamp microscope exam, or using a special camera to photograph the retina.

In each of these methods, the doctor is assessing the retina and choroid for certain signs of a choroidal nevus.

Most noticeable is the dark pigment that usually accompanies the nevus. The area of the choroidal nevus will be much darker brown than the rest of the retina.

Another characteristic that differentiates a choroidal nevus from other potential lesions is that a nevus is completely flat.

The flat nevus will not cause distortion, blood vessel obscuration, or other signs that an elevated lesion would.


Choroidal Nevus vs. Choroidal Melanoma

A choroidal nevus is a small, fairly insignificant finding that does not impact vision or eye health.

On the other hand, choroidal melanoma is a serious eye problem that is often related to a larger cancer within the body.

Determining whether a lesion is a nevus or melanoma is the highest priority when evaluating a pigmented area of the choroid.

If there is elevation, indistinct borders, or obscuration of blood vessels, a referral for further evaluation and consideration of treatment is needed.


Treatment for Choroidal Nevus

If a lesion is determined to be a choroidal nevus, it is often only monitored yearly as there is no treatment needed.

Using retinal photography, the lesion can be imaged and compared yearly to evaluate for any growth or other changes.
If there are new changes, it is likely that the nevus has transformed into melanoma and needs treatment.


Dr. Anthony Spina and the staff of Premier Eye Associates specialize in glasses, soft contact lenses, hard contact lenses, and medical eye exams. Call our eye doctor in Auburn, AL today at (334) 539-5391 or schedule an appointment online if you are interested in learning more about a choroidal nevus and how we can help differentiate it from a choroidal melanoma. Our optometrist provides only the highest quality eye care services amongst eye doctors in the Auburn Alabama area.

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