Yes, you can get freckles in your eyes—no, you shouldn’t ignore them

But, fun fact: You can also get freckles on your eye-and, like other freckles, they're not always totally harmless.

Real quick: Birthmarks or moles anywhere on the body are called nevi (one freckle would be a nevus), but yes, they can show up in the eye too.

And, just like other moles or birthmarks, they’re essentially just a colored growth on your eye, according to the American Academy of Ophthalmology. You can have a nevi in the front of your eye, near the iris, or under the retina in the back of your eye (this one's called a choroidal nevus), per the AAO.

Nevi are made up of cells called melanocytes, which are the same cells that make the pigment of your skin, hair, and eyes, explains Nirali Bhatt, M.D., an assistant professor of clinical ophthalmology at Penn Medicine. “Most of the time, melanocytes are spread evenly throughout body tissue [but] sometimes these cells can cluster together, forming nevi,” she says.

Nevi aren't necessarily rare, says Carol Shields, M.D., chief of the Ocular Oncology Service at Wills Eye Hospital, but they're most common among Caucasians-about 5 percent have them-because light-colored eyes, fair skin, and burning easily in the sun are also risk factors. But "all races are at risk for a freckle in the eye," Shields adds.

Spending tons of time in the sun can also up your odds of developing eye freckles. A 2017 study published in the journal Investigative Ophthalmology & Visual Science found that eye freckles were more often found in older individuals with a history of sunburns and severe sunburns resulting in blisters.

While researchers don't know the exact role of sunlight in eye health, it's believed that "high amounts of chronic sunlight exposure" can lead to eye freckles, per the study authors.

You may see a nevus if it shows up in the front of your eye near the iris, but you likely won't be able to detect one if it pops up behind your retina. And, because you won't feel either one, you’ll probably just hear about it during a routine eye exam, says Bavand Youssefzadeh, D.O., an ophthalmologist in Los Angeles

In rare cases, abnormal blood vessels can grow around the freckle, causing retinal detachment (when the light-sensitive layer of tissue that lines the inside of your eye-your retina-pulls away from the supportive tissue) and a loss of vision, Bhatt says. But again, that's rare.

Just like you need to check in with your doctor regularly to keep tabs on the moles or birthmarks on your skin, you also need to have your eye freckles monitored. In rare cases, they can actually transform into melanoma, the most deadly form of skin cancer, Bhatt says.

If you have a small freckle that looks normal, it’s a good idea to have it checked again in six months, and then every year, Bhatt says. But if it’s large or looks suspicious, you’ll need to have it looked at every four to six months, Youssefzadeh says.

The goal in monitoring the freckle closely is that doctors can intervene quickly if it turns into melanoma, Shields says-and the faster doctors act, the better your prognosis. And if your eye freckle does turn into melanoma, it can be treated with radiation, laser surgery, or in rare cases, removal of the eye, Youssefzadeh says.

If do you have an eye freckle, don’t panic and assume that it means something bad. “I don’t want people to worry,” Shields says. “Maybe one in 8,000 freckles in the eye will turn into a melanoma. It’s way less than 1 percent.” Still, it’s important to be on top of your eye freckle, just in case.

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