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Should I be Concerned About an Eye Freckle?

A nevus, also known as a pigment spot or freckle, can be found on the skin and in the eyes of many humans. A choroidal nevus is a benign lesion, caused by the clumping of pigmented cells normally found in the back of the eye, and can be found during a routine eye examination. They usually do not cause any visual symptoms, thus most patients are unaware they even have them. They are believed to be more common in Caucasians than in African Americans, Hispanics, and Native Americans. A nevus can be a dark or light lesion depending on the amount of pigment and it can vary in size and shape.

A choroidal nevus rarely requires treatment. If the choroidal nevus has orange pigmentation, is leaking fluid, or has a thickness of 2 mm or more it is more suspicious for becoming a cancerous tumor called a malignant melanoma or a choroidal melanoma. Retinal photography is typically used to document the size of the choroidal nevus so that it can be evaluated over time for changes.

Depending on its appearance, patients with a choroidal nevus should have their eyes examined at least every year. Only your eye doctor can look inside your eye to see if the choroidal nevus has changed. If the choroidal nevus has orange pigment or has become thicker as mentioned above, it should be checked more often. Findings like these should be evaluated with special tests for evidence of growth or malignant transformation.

If your eye doctor believes the nevus looks suspicious, he or she may recommend your examination include the use of ultrasound, a specialized imaging device (OCT),or an angiogram of the inside of your eye, referred toas a fluorescein angiography. This type of test involves injecting a special dye into your arm, observing, and photographing the blood vessels in and around the nevus as the dye travels through the back of the eye.

At Cockrell Eyecare Center, the specialized instruments used to evaluate these types of lesions include an Optomap Retinal Camera, Cirrus OCT, and B-scan ultrasound. The Optomap is a specialized retinal camera that allows a 200-degree retinal photograph to be taken in less than a second. The doctor can then review the photograph with the patient while the magnification and lighting are adjusted for maximum viewing. The Cirrus OCT uses scanning laser technology to take a specialized image of the area in question and virtually dissect that part of the retina. The B-scan ultrasound allows size and elevation to be determined.

The detail of the data collected during our exam is the most advanced technology available today. Upon leaving our office, we can provide you with copies of your photographs or images. It is a good idea to keep a picture of your choroidal nevus in the event you change eye doctors. The picture can be compared in future examinations to help determine if the nevus has changed.

There is no way to safely remove a choroidal nevus, nor is there a reason to. It is recommended to have the nevus observed by your eye doctor on a yearly basis and documented with photography.

We encourage all our patients to have yearly eye health evaluations to evaluate for and rule out findings like nevi. If you have questions regarding your eye health, please contact our office in Stillwater at 405-372-1715. We also invite you to visit our website at and like us on Facebook at Cockrell Eye Care Center!