A choroidal nevus is an area of benign discoloration in the eye. It can usually only be seen with the assistance of specialized equipment of the type used in eye exams. Choroidal nevi can sometimes become malignant, with malignancy emerging in around one in every 20,000 cases. There are no treatments available, and treatment is not usually needed in any case, because the choroidal nevus usually have no ill effects on the patient.
Nevus is a term which people might more familiar with in the form of the word “freckle.” Just like the skin, the eyes contain cells which produce pigment, and these cells can cause freckles to develop inside the eye, just as they do on the skin. The freckle will show up when a doctor examines the eye, but should otherwise be unobtrusive. A nevus is not the same thing as a discoloration in the iris of the eye which may look like a freckle.
Ophthalmologists usually identify nevi during routine examinations. The general recommendation to a patient is to do nothing, but to attend regular follow up eye exams, ideally every year. During these exams, the doctor can check the choroidal nevus to see if it has changed shape, size, or consistency. If changes are observed, then a more aggressive tack can be taken to determine what is going inside the eye and why.
A patient who knows that she or he has a choroidal nevus should make sure to mention it to eye care professionals before appointments. Knowing ahead of time will allow the doctor to specifically look for the nevus, and will alert the doctor to the fact that the patient is aware and is pursuing ongoing monitoring or care so that changes can be addressed if they occur. When patients change care providers, it is also a good idea to get a copy of the patient's chart to bring to a new doctor, as it will include information about when the choroidal nevus was first identified, and whether or not any changes have been noted.
Many people have a choroidal nevus and remain blissfully unaware, either because they do not get regular eye exams, or because the small discoloration is missed during an eye exam. For those who do, the literal eye freckle is not a major cause for concern, although it is a good idea to be aware of it and to be proactive about eye care.