Choroidal Nevus

A Simple Eye Freckle

Eye freckle. 2008 Troy Bedinghaus, licensed to, Inc.

You've just completed your annual eye exam and your doctor says you passed with flying colors. However, while examining the inside of your eyes, he discovered a small choroidal nevus. Although the name sounds complicated, a choroidal nevus is simply a freckle inside the eye.

What Is a Choroidal Nevus?

A choroidal nevus is the name given to a spot, freckle or mole that appears inside the eye or on the eye's surface.

Sometimes detected during a dilated eye examination, these pigmented spots are usually flat and slate-greyish in color. Choroidal nevi are commonly found in the choroid, a blood vessel-rich layer lying between the retina and the sclera. Although they are not necessarily a "normal" finding in our eyes, they are quite common and may not represent anything wrong with the eye. Nevi vary from patient to patient but most look very similar and have certain traits that eye doctors are very familiar with. Your doctor will document this finding in your chart if it is detected during a routine eye exam.

Are Nevi Dangerous?

Choroidal nevi are not usually harmful. However, just like a freckle on your skin, if it changes in color, size or shape, you should let your doctor or a dermatologist know about it. It is difficult to observe a freckle in your own eye. You should follow your eye doctor’s recommendations on when to come back or how to observe it in the future.

Typical treatment involves taking a digital photograph for documentation. Your doctor will then schedule you to come back in 3 to 6 months to look for possible changes. If your doctor has seen you for several years, then he or she may feel comfortable monitoring the nevus every 12 months. If it appears unusual, however, you may be asked to return in a shorter period of time.

Occasionally, certain diagnostic tests may be ordered, or you may be referred to a retinal specialist for a second opinion.

Do people experience symptoms of choroidal nevi

Most choroidal nevi do not cause symptoms. Most nevi are discovered during a routine eye examinations. If a nevi grows and disrupts the surrounding tissue, it may cause fluid or blood to leak out of the tissue. If this occurs, it can cause a retinal tear or detachment. Often, people with a retinal tear or detachment will complain of seeing flashes of light or new floaters in their visual field.

What can I do to to make sure I don't have a choroidal nevi?

Choroidal nevi are fairly uncommon. Many of us have retinal pigmentation variations that are more common but true choroidal nevi are fairly uncommon, especially large nevi. The best recommendation is to have annual eye examinations which include dilating the eyes with special eye drops. If you have a nevi, then your doctor may see you every 3-6 months for the first year or two when first identified.

Possible Complications

Choriodal nevi are benign, however, your eye doctor is trained to watch closely for the development of a choroidal melanoma, a tumor found in the eye. In rare cases, the nevus must be biopsied and examined for melanoma (cancer) cells. Choroidal melanomas are malignant tumors and must be treated.


Sowka, Joseph W. OD, FAAO, Andrew S. Gurwood, OD, FAAO, and Alan G. Kabat, OD, FAAO. Handbook of Ocular Disease Management, Choroidal Nevus. 2000-2001.

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