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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
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Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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I went for an eye test yesterday and was told I have a freckle

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I went for an eye test yesterday and was told I have a freckle in my eyeball. The opt said he was 99.9 percent sure it was fine and there was no sign of malignancy but because I have never been to this particular optician and my last appointment was years ago he is refering me to the hospital to check it out. Also my uncle has been diagnosed with a malignant melanoma in his eye so I was very nervous about them finding something and now they have. He said I will have to wait a while for the hospital as its not urgent but I am so scared I have the same thing as my uncle. I explained the situation with my uncle when I went in. They opt said I have nothing to worry about but then why is he refering me?Also would the optician know if there was any cancer in the freckle.
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Stan replied 6 years ago.

Welcome to JA.

In general, freckles (or moles/nevus) in the eyes are common and not harmful. They rarely turn into malignancy. Malignant melanoma are generally not inherited. Prolonged exposure to sunlight (over may decades) can be an inducing factor. This is the reason for recommendation that people should generally wear good UV sun protective glass when in the bright sunlight. Depending on where the freckle is located, the type, size and location will help the doctor classify and monitor it in the future.

The evaluation by the eye doctor could includes the following:

1. Determine the location, size, exact color, shape or any other characteristics

2. Perform at complete eye examination with dilation to ensure no other sign of abnormality.

3. Take picture of the freckle/nevus/mole to allow the future comparison of the size and any change in shape, color

4. Perform ultrasound study and OCT if necessary to better understand the characteristics of the freckle/nevus/mole. Please, note that freckles are also referred to as nevus or mole.

In general, the freckles which are located at the back of the eye, it are either a choroidal nevus or congenital retinal nevus. If on the conjunctiva it is called conjunctiva nevus. These generally do not become cancerous. A significant portion of the general population have freckles. The reason the optician is referring you to the ophthalmologist is due to the established medical protocol - which required that eye freckles be evaluated by the trained eye specialist (Ophthalmological retina specialist) to record the initial characteristics of the freckle. The optician as you know is not officially trained and certified to evaluate and treat such eye lesions, but only certified to fit glasses. However, with experience the optician can at least recognize freckles because eye freckles are very common among the population. So, I suggest that you stop worrying - you mostly likely have the regular common freckles, notwithstanding the fact that your uncle has malignant melanoma. Both are most unlikely related to one another. Please, keep your appointment with the eye doctor so that the freckles can be properly evaluated and size noted.

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