Choroidal Nevus: Signs, Risks, and When to See a Retina Specialist

A choroidal nevus is a flat, mole-like spot inside the eye. Most are benign and never cause trouble, but a small percentage can change over time. At West Texas Eye Associates, our retina team, including Douglas Jin, MD, evaluates, documents, and monitors choroidal nevi so you understand your risk and know exactly when treatment is necessary.

What Is a Choroidal Nevus?

A choroidal nevus is a pigmented lesion in the choroid (the vascular layer beneath the retina). It is usually discovered during a dilated eye exam and looks gray-brown on retinal photos. Most people have no symptoms; occasionally, patients notice blurred vision, flashes/floaters, or a shadow if fluid develops under the retina. Authoritative clinical overviews note that nevi are common and typically stable, but they must be differentiated from early melanoma and other mimickers.

Why Monitoring Matters

Large data sets from tertiary centers show that a small fraction of nevi grow into melanoma over time; risk rises when specific features are present (see below). In long-term cohorts, cumulative transformation risk across many patients remains low but non-zero, reinforcing the need for periodic imaging and follow-up.

The Major Risk Features (TFSOM-DIM)

Specialists use the TFSOM-DIM mnemonic to flag higher-risk nevi:

• Thickness >2 mm
• Fluid (subretinal)
• Symptoms (decreased vision, flashes/floaters)
• Orange pigment (lipofuscin)
• Margin near the optic disc
• Diameter >5 mm
• Imaging features (I): ultrasonographic Medium reflectivity/hollowness, autofluorescence changes, OCT abnormalities

These features correlate with growth risk and guide how closely we follow you or when we involve an ocular oncologist.

How We Evaluate and Track a Nevus

• Dilated retinal exam & color fundus photography to document baseline size and borders
• Optical Coherence Tomography (OCT) to detect subtle subretinal fluid or retinal changes
• Fundus autofluorescence to look for orange pigment/lipofuscin
• B-scan ultrasound to measure thickness and internal reflectivity
• Risk stratification + schedule for follow-up (for many patients, 6–12 months; sooner if features change)

Modern imaging improves the detection of the risk features above and helps separate benign nevi from small melanomas.

When a Nevus Needs Treatment

Most nevi are observed only. If a lesion shows growth or high-risk features, we coordinate with ocular oncology to discuss options (e.g., plaque radiotherapy) appropriate for small choroidal melanoma. Patient-facing resources on ocular melanoma provide a useful overview of why early detection matters.

Symptoms You Shouldn’t Ignore

• New or worsening blurred or distorted central vision
• Flashes, an increase in floaters, or a dark curtain/shadow
• Sudden trouble reading or recognizing faces

If any of these occur, call our retina team promptly for an urgent evaluation.

Your Retina Specialist: Douglas Jin, MD

Douglas Jin, MD, is a retina specialist in Lubbock who cares for patients with choroidal nevi and other retinal conditions. He uses modern retinal imaging (OCT, fundus autofluorescence, ultrasound) to document baseline size and watch for risk features, and he coordinates with ocular oncology if treatment is indicated.

Your Visit to West Texas Eye Associates

You’ll receive a clear, illustrated report with photographs and measurements, your personalized risk level, and a follow-up plan. We’ll tell you exactly what to watch for at home and when to return sooner than scheduled. Your evaluation may be with Douglas Jin, MD, our retina specialist in Lubbock.

Living With a Choroidal Nevus: Practical Tips

• Keep annual dilated eye exams (or your personalized interval)
• Tell your doctor about new visual symptoms right away
• Bring previous photos/reports if you’re new to our practice
• Protect eyes from UV and manage cardiovascular risk factors; while evidence is evolving, healthy habits support overall ocular health

FAQ

Is a choroidal nevus cancer?

No. It’s a benign “mole” inside the eye. A small percentage of individuals develop changes that suggest melanoma, which is why regular monitoring is crucial.

How often should I be checked?

It depends on size and features. Many patients are seen every 6–12 months; higher-risk nevi are followed more often.

What tests will I have?

Typically, retinal photos, OCT, autofluorescence, and ultrasound to measure thickness. These tests are painless and take just minutes.

What raises the risk that a nevus will grow?

Thickness over 2 mm, subretinal fluid, symptoms, orange pigment, margin near the optic disc, larger diameter, and certain ultrasound findings (TFSOM-DIM).

If it turns into melanoma, what are the treatments?

Options may include plaque radiotherapy or other modalities delivered by ocular oncology; your retina specialist will coordinate care. Patient resources on uveal melanoma are available from the National Eye Institute.

We Can Help, Today

Most choroidal nevi remain asymptomatic for life, but they still require expert evaluation and modern imaging. If you’ve been told you have a nevus—or you’re noticing new visual symptoms, schedule a comprehensive retina evaluation at West Texas Eye Associates. We’ll document a precise baseline, explain your risk, and set a follow-up plan tailored to you.