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Freckles and birthmarks can occur anywhere on the body, including in or around your eyes.
Eye freckles are called nevus (more than one are called nevi), and they are colored growths in your eye. (Learn More) They can occur on the inside or outside of your eye.
Birthmarks are areas of discolored and often raised skin that infants are born with. There are several different kinds of birthmarks, and they can appear near the eye. (Learn More)
Eye nevus and birthmarks near the eye need to be monitored regularly and should be examined if there are changes or if they are impacting vision. (Learn More)
Nevus and birthmarks are often benign and don’t need treatment. If they impact vision or become cancerous, they will need to be treated with radiation, laser therapy, or surgery. (Learn More)
Eye nevi can occur under the retina in the back of your eye, in the front of your eye, or in the iris. They are colored growths made up of clumped cells called melanocytes. These cells are the ones that produce melanin, the pigment that colors your eyes and skin.
These eye freckles may be present at birth, or they can form later in life.
Types of nevus include:
- Iris freckles. Typically harmless, these are small dark brown spots on the surface of the colored portion of the iris.
- Conjunctival nevus. This is a yellow or brown freckle on the conjunctiva, or the clear film, that covers your eyeball. It is usually harmless, but it can grow and become cancerous.
- Iris nevi. These are freckles on the iris that are larger and can also grow down into the stroma of the eye and get larger over time. They are typically benign, but they need monitoring.
- Choroidal nevus. These are found under the retina in the choroid. They are only visible through an eye exam. They can be many different colors and may be cancerous.
Birthmarks Near the Eye
Birthmarks are common and usually show up in infants at birth or soon after. They are usually harmless, and many even disappear with time.
They form due to an overproduction of pigment in the skin or an overgrowth of blood vessels. They can appear anywhere on the body. They can get very close to the eye, showing up on the eyelids, under the eye, or in the skin in the inner corner of the eye.
Birthmarks that can occur near the eyes include:
Port wine birthmarks.These are deep red or purple blood vessel birthmarks. They can become thick and bumpy, and they often lead to increased eye pressure.
Salmon patches.These blood vessel birthmarks are faint red and often disappear over time.
Strawberry hemangioma.These red, raised marks appear at or shortly after birth. They can grow quickly in the first six months but then disappear with age.
Cavernous hemangioma.Deeper in the skin than a strawberry hemangioma, this type often appears blue in color and also generally shrinks with age.
When to Have Eye Freckles & Birthmarks Checked
When it comes to eye freckles and birthmarks near or in the eyes, they will typically need to be monitored closely to ensure that they are not impacting vision, getting larger, causing pain, or changing in color or shape. If any of these things occur, talk to your eye doctor as soon as possible.
If you have nevi, your eye doctor will want to keep an eye on them, measuring, and examining them regularly to ensure they are not changing or becoming cancerous. In the case of birthmarks, they will need to be watched to ensure that they are not increasing eye pressure or impeding normal vision.
Most birthmarks and nevi are benign and harmless. However, it is a good idea to keep close watch on them to make sure that they don’t change and become problematic.
Treatments for Nevi & Birthmarks
An eye nevus can become cancerous and turn into melanoma with time, so they need to be consistently monitored. They only require treatment if they are impacting vision or are cancerous. In this case, treatment options are evaluated.
Treatments for cancerous nevi can include the following:
- Laser therapy
- Removal of the eye
Often, treatments for a cancerous nevus can be more harmful than the nevus itself. As a result, nevi are often monitored instead of managed directly. Talk to your eye doctor about the best options.
Birthmarks often go away on their own without treatment, or they are not harmful. If they are too close to the eye and getting larger, they can impact eye pressure and vision.
When birthmarks are large or on the eyelid, they need to be evaluated by your health care provider who can refer you to an ophthalmologist. Treatment options can include laser therapy or surgery to diminish them. Medications like propranolol, a blood pressure medication, are also effective in treating hemangiomas by slowing their growth.
Your eye doctor is your best ally in managing eye freckles and birthmarks near the eye. They can help you monitor them and decide when treatment options can be more helpful than harmful.
Talk to your doctor immediately if you feel eye pain or pressure, changes in your vision, or notice the shape, size, or color of your eye freckle or birthmark changing.
Nevus (Eye Freckles). (October 2020). American Academy of Ophthalmology (AAO).
When You Should Worry About a Birthmark. Everyday Health.
Nevus Diagnosis and Treatment. (October 2020). American Academy of Ophthalmology (AAO).
Birthmarks in Infants. (2021). Johns Hopkins Medicine.
Haemangioma. Royal National Institute of Blind People (RNIB).