Can Nevus Develop in Adults?
SEP 22, 2014
After noticing a small brown patch (1 mm at most) on the white of my eye a month ago, I visited an eye doctor who said it is just a nevus (a mole-like growth on the eye) which only required observation in case it changes. Is it unusual to be diagnosed with a nevus on the sclera (white of the eye) at 27 years old? It seems I'm reading a lot are typically present at birth.
You are correct. Conjunctival nevi are areas of increased pigmentation on the surface of the eye that are present from birth. Changes in appearance of nevi are concerning and should be evaluated by your ophthalmologist.
Newly arising pigmentation can also occur. One condition, Primary Acquired Melanosis (PAM), reported in up to 36 percent of light skinned individuals, is where new patches of pigmentation arise on the surface of the eye. Occasionally these lesions contain atypical cells that can progress to melanoma (cancer) and therefore should be evaluated by your ophthalmologist. Similar pigmentary changes in dark-skinned individuals almost never progress to melanoma and are known as Benign Epithelial Melanosis or Racial Melanosis. New pigmentation changes can also be due to medications, chronic ocular surface inflammation, or hormonal abnormalities such as in Addison's Disease.
Your ophthalmologist will evaluate each lesion looking for any concerning characteristics that would warrant a biopsy (when a small sample of cells is removed and tested in a lab). They can be followed by serial eye exams (seeing your doctor regularly—once a year or more often) or with photographs. If you are concerned about any lesion in your eye, let your ophthalmologist know.