Skin cancer screening at the eye doctor? Actually, yes.

Whenever I spot a new mole on myself or a family member, it takes me less than two minutes to examine it from every angle. And if it looks even slightly unusual to me, off to the dermatologist I go. I’m sure many people feel the same way: we all know by now how important skin cancer screening is. Sunscreen, skin checks, the ABCDE rule—we’re all well aware of them.

But let’s be honest: Who thinks about the skin in the eye?

Most people know that the eye has the cornea at the front and the retina at the back. Less well known, however, is that there is a third layer in between: the choroid. It supplies the eye with blood and nutrients, and it, too, can develop pigmented spots, much like our skin.

Part of this choroid is even visible from the outside, namely the iris. Liver spots can develop there, which can sometimes be seen with the naked eye. However, the larger part of the choroid lies deep inside the eye and remains hidden from us. This area can only be viewed by an ophthalmologist when the pupil is dilated and the eye is thoroughly examined.

I still remember one of my first patients as a young ophthalmologist: an athletic young man who had actually come in for a routine checkup and had no symptoms. By chance, a suspicious spot was discovered, which later turned out to be a malignant tumor of the choroid—a choroidal melanoma. Fortunately, it was detected in time.

Since then, I often think: We pay such close attention to every mole on our skin, but those in the eye usually go unnoticed. Yet the same rule applies here: early detection is crucial!

That’s why it’s worth asking your eye doctor during your next checkup if they can dilate your pupils and thoroughly examine the choroid. Suspicious pigmented spots can be photographed and monitored over the years. This way, you can detect any changes early on.

Don’t worry—in the vast majority of cases, such spots are harmless. But not always. And the sooner you detect abnormalities, the better you can respond.

My conclusion: The skin doesn’t stop at the edge of the eyelid. A thorough look inside the eye can save lives—because early diagnosis, in particular, opens up the best treatment options.