What Is an Eye Freckle (Nevus)?
These iris specks are not rare, but they might signal too much sun exposure.
Medically reviewed by Andrew Greenberg, MD
An eye freckle (nevi) is a cluster of abnormal melanocytes, or cells that produce melanin that sit on the surface of the iris. Melanin is a pigment that gives your eyes, hair, and skin color. Several types of eye freckles (nevus) may develop inside or outside your eye.
An ophthalmologist can detect eye freckles during a routine eye exam. Eye freckles typically do not cause symptoms or require treatment. Although rare, some eye freckles might develop into melanoma, a severe skin cancer.
It’s not rare to have an eye freckle. Some evidence suggests that about 50% of people are born with or develop an eye freckle. Read on to learn what causes an eye freckle, treatments, complications, and more.
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Types of Eye Freckles
An eye freckle might develop outside or inside of the eye. The location determines the type. Eye freckles are usually benign (non-cancerous). Still, you might need to monitor some eye freckles for changes that may signal cancer.
Conjunctival Nevus
A conjunctival nevus appears outside your eye, on the conjunctiva (the clear film covering your eyeball). This eye freckle is very common. The spot can be yellow to brown and get lighter or darker over time.
Iris Freckles
Iris freckles are small dark spots on the inside of your eye. These eye freckles appear on the iris, or the colored part of your eye, and are similar to freckles on your skin.
Iris Nevi
Iris nevi are similar to, but larger than, iris freckles. An ophthalmologist (eye specialist) will need to examine your eye to determine whether the spots are iris freckles or nevi.
Iris nevi also appear on the iris but can extend into the stroma, or the cornea's middle layer. The cornea, located at the front of your eye, adjusts to light and helps you see clearly.
Choroidal Nevus
A choroidal nevus is a spot found on a layer of tissue called the choroid, located under the retina (tissue at the back of your eye). Unlike other eye freckles, a choroidal nevus occurs inside your eye.
A choroidal nevus could develop into melanoma or cancer of the cells responsible for making pigment. An ophthalmologist will check to make sure it's not cancerous.
Related: Freckles on Your Wrist or Hand? Here's What Causes Them
Eye Freckle Symptoms
For most people, an eye freckle may be nothing more than a cosmetic annoyance for some people. Eye freckles usually do not cause any symptoms.
Rarely does an eye freckle affect your vision. For example, a choroidal nevus might cause blurred vision if you have one under the macula, or the center layer of the retina. Still, most people with a choroidal nevus only know they have one once they get an eye exam.
What Causes an Eye Freckle?
The exact reason why eye freckles develop is unknown. People are usually born with eye freckles. You can sometimes develop them because of hormonal changes during pregnancy or puberty.
Ultraviolet (UV) exposure is another possible cause of eye freckles. The sun gives off UV rays. Experts advise wearing sunglasses with UV protection while outdoors. Some evidence suggests that eye freckles are likelier to develop on the iris's lower outer part. Your eyebrows and nose help protect the iris's inner and upper parts from the sun.
Risk Factors
Anyone can develop an eye freckle. Still, research has found that some people have a higher risk of eye freckles than others.
Risk factors include:
Age spots (actinic lentigines)
A high number of sunburns
Older age
Sun-damaged skin
How Is an Eye Freckle Diagnosed?
An eye freckle will show up during a routine eye exam. An ophthalmologist may take a picture of the eye freckle to monitor changes over time. An ophthalmologist can only diagnose a choroidal nevus during an eye exam since it's inside your eye.
Eye freckles are most often benign. Still, eye freckles sometimes develop into melanoma, like a mole on your skin. Melanoma is a severe type of skin cancer. It's essential that you receive routine eye exams. They can usually detect melanoma changes within one or two years.
Treatments for an Eye Freckle
You do not usually need to treat most eye freckles. You may require treatment if your ophthalmologist suspects the eye freckle might be melanoma.
Ways to treat melanoma of the eye include:
Chemotherapy, which helps treat cancer that metastasizes (spreads) to other body parts
Immunotherapy, which helps support your immune system
Lasers
Radiation therapy
Surgery, including surgery to remove your eye (in severe cases)
How To Prevent an Eye Freckle
You cannot prevent eye freckles that you are born with. In contrast, protecting your eyes from the sun helps lower your risk of developing an eye freckle later in life.
Experts suggest wearing well-fitted sunglasses and a wide-brimmed hat to help prevent UV exposure to your eyes. You might consider limiting how often you are outdoors between 10 a.m. and 4 p.m. The UV index, which measures how strong UV rays are, is typically highest during that time.
Complications
Although eye freckles rarely lead to complications, it may happen. For example, there's a slight risk that eye freckles develop into melanoma. A study published in 2020 found that people with pre-cancerous skin changes were likelier to have eye freckles than others. Though, more research is needed.
You might develop glaucoma if an eye freckle elevates and grows. Glaucoma includes several eye diseases that damage the optic nerve, which sends signals to your brain to create images of what you see. Glaucoma causes blindness if untreated.
Related: Why You Might Have White Spots on Your Skin
A Quick Review
An eye freckle is a cluster of pigment-producing cells that develop inside or outside your eye. An ophthalmologist can detect eye freckles during a routine eye exam. You are unlikely to develop symptoms or require treatment. Still, some eye freckles may become melanoma, a severe skin cancer.
Practicing sun safety helps reduce your risk of eye freckles and melanoma. Opt for sunglasses and a wide-brimmed hat when outdoors. Try limiting sun exposure between 10 a.m. and 4 p.m., when the UV index is highest.
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