• Nevus Diagnosis and Treatment

    Reviewed By James M Huffman, MD
    Oct. 28, 2020

    Nevus Diagnosis

    Your ophthalmologist can find a nevus during a routine eye exam. In some cases, your ophthalmologist may use imaging technology like OCT to examine a nevus more closely, such as a choroidal nevus.

    The ophthalmologist will take a picture of the nevus. They will compare pictures over time to see if there are any changes in its size or shape.

    Your ophthalmologist may ask you to have the nevus re-checked in six months. If the nevus does not change over a year or two, it is not likely to be a melanoma. But nevi can change to a melanoma as you age, so you should have it checked by an ophthalmologist regularly. Make sure to follow the exam schedule your ophthalmologist gives you.

    Nevus Treatment

    Most nevi do not need to be treated since they will not affect your vision or lead to any health problems. The only reason you might need treatment for a nevus is if your doctor suspects it might be melanoma.

    In very rare cases, a nevus on the outer wall of the eye that affects the eye’s appearance may be removed with surgery.

    Your ophthalmologist will not risk damaging your eye by removing a harmless nevus inside the eye. Your doctor will recommend treatment only if a nevus becomes cancerous. Treatment may involve radiation, surgery, laser therapy, or removal of the eye. Sometimes, waiting and watching the nevus closely is a treatment option. This is recommended when the side effects of cancer treatment can be more problematic than helpful.

    When to See Your Eye Doctor About That Eye Freckle

    You’ve noticed a spot that looks like a freckle in your eye. You don’t feel anything unusual, and you are fairly certain it is not a problem. But you should get it checked by an ophthalmologist.

    While it is most likely harmless, an ophthalmologist will want to examine and closely monitor the nevus to make sure it does not change. Changes mean the nevus could become cancer.

    Other reasons to see an ophthalmologist include:

    • You notice your eye freckle has grown or changed its shape or color
    • You have eye pain
    • You see flashing lights
    • You notice other changes in your vision