Intraocular Leiomyoma is a rare, non-cancerous tumor made of smooth muscle cells that grows inside the eye. It most often comes from the uveal tract—the colored part of the eye—especially the ciliary body, but it can also start in the iris or the choroid behind the retina. These tumors grow slowly, rarely spread outside the eye, and most patients are young to middle-aged adults, with women affected about twice as often as men PubMedEyeWiki.
Intraocular leiomyoma is a very rare, non-cancerous (benign) tumor made up of smooth muscle cells that arise inside the eye, most often in the uvea (the pigmented layer beneath the white of the eye) or ciliary body (the part that makes fluid in the eye) PubMed. Under the microscope, it shows tightly packed spindle-shaped cells that stain positive for smooth muscle actin, distinguishing it from more common pigmented tumors like melanoma ScienceDirect. It tends to occur in younger adults (average age ~35 years) with a slight female predominance when in the ciliary body, and can mimic melanoma by presenting as an amelanotic (non-pigmented), firm mass seen on eye exam Nature.
An intraocular leiomyoma is a benign smooth muscle tumor of the eye. “Benign” means it does not invade other tissues or spread to distant organs. Inside the eye, it arises from smooth muscle cells that normally help the iris open and close and control fluid drainage around the lens PubMedEyeWiki.
Under the microscope, these tumors appear as bundles of long, spindle-shaped cells with “cigar-shaped” nuclei and very few dividing cells. They stain positive for smooth muscle markers (actin, desmin) and negative for melanoma markers (HMB-45, S-100), which helps doctors tell them apart from more dangerous tumors like uveal melanoma EyeWiki.
Types
Intraocular leiomyomas can be classified by their cellular origin and by their location:
Mesectodermal leiomyomas
Originate from neural crest–derived smooth muscle in the iris sphincter or dilator muscles.
Show both muscle and nerve features under special stains EyeWiki.
Mesodermal leiomyomas
Arise from smooth muscle cells around blood vessels in the uveal tract.
Share features with smooth muscle tumors elsewhere in the body EyeWiki.
By location:
Iris leiomyoma – in the colored front part of the eye.
Ciliary body leiomyoma – in the ring of tissue that makes fluid and holds the lens.
Choroidal leiomyoma – in the layer behind the retina.
The ciliary body is most often involved, followed by the iris, with choroidal tumors being the rarest EyeWiki+1.
Possible Causes & Contributing Factors
The true cause of intraocular leiomyoma is not known. Most cases seem to happen by chance, without clear risk factors. However, experts have proposed several possible contributing factors:
Smooth muscle cell overgrowth
An abnormal trigger makes smooth muscle cells multiply too much. EyeWikiNeural crest cell mis‐differentiation
Some iris muscle cells arise from early nerve tissue (neural crest), which may behave differently. EyeWikiVascular smooth muscle proliferation
Muscle cells around eye blood vessels may turn into a tumor. EyeWikiHormonal influences
Many tumors have estrogen and progesterone receptors, suggesting hormones may play a role. EyeWikiGenetic mutations
Changes in genes that control muscle cell growth might trigger a tumor. NCBIChronic inflammation
Long-standing uveitis or other eye inflammation could stimulate muscle cell growth. WebEyeTrauma or surgery
Injury or prior surgery to the eye might lead to abnormal healing and tumor formation. WebEyeEmbryonic cell rests
Tiny bits of muscle-forming tissue left over from development may later turn into a tumor. EyeWikiHormone receptor dysregulation
Overactive hormone signals in smooth muscle cells could push them to grow. EyeWikiLocal growth factors
Abnormal levels of proteins that encourage cell growth might be involved. PubMedOxidative stress
Damage from free radicals in eye tissues may trigger cell changes. PubMedAutoimmune reactions
The immune system might accidentally target muscle cells, causing repair and overgrowth. WebEyeAge‐related changes
Most tumors occur in adults 30–40 years old; cell aging processes might play a role. PubMedFemale sex predilection
Women have about double the risk, possibly due to estrogen effects. EyeWikiPregnancy
Hormone changes during pregnancy might fuel tumor growth in rare cases. WebEyeSystemic leiomyomas
A few patients with uterine fibroids also develop eye leiomyomas, hinting at shared causes. PubMedEnvironmental toxins
Exposure to certain chemicals could damage DNA in smooth muscle cells. PubMedViral infections
Some viruses can insert genes into host cells and cause tumors (hypothetical). NCBIEpigenetic changes
Chemical modifications of DNA that do not change the gene sequence might switch on growth genes. PubMedUnknown sporadic events
In most patients, no clear cause is found, and the tumor appears “out of the blue.” EyeWiki
Common Symptoms
Because these tumors grow slowly, many people have no symptoms until the tumor is large enough to interfere with vision or eye structures:
Blurred vision – images look fuzzy or out of focus WebEye
Flashing lights (photopsia) – seeing flashes when you move your eyes WebEye
Floaters – small spots or threads drifting across your vision WebEye
Eye pain – aching or sharp pain, especially if the tumor presses on structures WebEye
Light sensitivity (photophobia) – bright lights feel uncomfortable EyeWiki
Glare – seeing halos or rings around lights EyeWiki
No symptoms (asymptomatic) – often found by chance on an eye exam EyeWiki
Sudden eyelid swelling – rare acute presentation with puffiness around the eye EyeWiki
Severe vision loss – vision may drop to only perceiving light in advanced cases EyeWiki
Secondary glaucoma – high eye pressure causes halos, vision changes, and pain WebEye
Exudative retinal detachment – fluid under the retina blurs vision sharply WebEye
Retinal detachment (secondary) – the retina peels away, causing flashing lights and floaters ScienceDirect
Macular edema – swelling at the central retina causes distorted vision ScienceDirect
Lens subluxation – the lens shifts position, leading to blurred or double vision WebEye
Visual field defects – patches of vision loss from mass effect EyeWiki
Diagnostic Tests
Diagnosing intraocular leiomyoma requires combining clinical exams, lab tests, and imaging to rule out melanoma and other eye tumors.
A. Physical Exam
Visual acuity – measures how clearly you see at different distances WebEye
Pupillary reaction – checks if pupils constrict normally in light WebEye
Intraocular pressure (tonometry) – detects high pressure from glaucoma WebEye
Slit-lamp exam – uses a bright microscope to view the front structures of the eye EyeWiki
B. Manual Test
Gonioscopy – places a special lens on the eye to look at fluid-drainage channels EyeWiki
C. Laboratory & Pathological Studies
Fine-needle aspiration biopsy (FNAB) – a thin needle samples cells from the tumor WebEye
Histopathology (H&E stain) – examines cell shape and arrangement under a microscope EyeWiki
Immunohistochemistry for SMA/desmin – confirms smooth muscle origin EyeWiki
Marker staining (S-100, HMB-45) – excludes melanoma by showing these markers are negative EyeWiki
Electron microscopy – sees ultra-fine cell structures when needed WebEye
D. Electrodiagnostic Tests
Electroretinography (ERG) – measures retinal cell responses to light EyeWiki
Electrooculography (EOG) – assesses the health of the retinal pigment epithelium EyeWiki
Visual evoked potentials (VEP) – records brain responses to visual stimuli EyeWiki
E. Imaging
Ultrasound biomicroscopy (UBM) – high-frequency ultrasound to view the tumor’s extent EyeWiki
B-scan ultrasonography – shows the tumor’s size and internal reflectivity PubMed
Optical coherence tomography (OCT) – cross-sectional images of retina and tumor surface EyeWiki
Fluorescein angiography (FA) – dye injected to highlight blood flow around the tumor EyeWiki
Indocyanine green angiography (ICG) – deeper blood vessel imaging for choroidal tumors EyeWiki
Magnetic resonance imaging (MRI) – detailed soft-tissue images of the eye and orbit WebEye
Computed tomography (CT) – picks up calcifications and bone changes near the tumor WebEye
Non-Pharmacological Treatments
Observation and Regular Monitoring
Simply watching the tumor over time with scheduled exams can be safe for very small, asymptomatic lesions, reducing unnecessary interventions. The mechanism is early detection of growth before vision is threatened PubMed.Ultrasound Biomicroscopy
High-frequency ultrasound captures detailed images of small tumors in the iris or ciliary body. Purpose: track size and internal reflectivity. Mechanism: sound waves reflect differently off solid tumors versus normal tissue WebEye.Optical Coherence Tomography (OCT)
OCT uses light waves to produce cross-sectional images of the retina and uvea. Purpose: monitor tumor thickness and effects on adjacent structures. Mechanism: light reflection differences between tumor and healthy tissue.Fundus Photography
Standardized color photos document tumor appearance over time. Purpose: detect subtle changes in color or borders. Mechanism: reproducible imaging of the back of the eye.Visual Field Testing
Automated perimetry checks for areas of vision loss that might indicate tumor pressure on adjacent retina. Mechanism: measures differential light sensitivity across the visual field.Argon Laser Photocoagulation
Laser beams create small burns around or within the tumor to induce scarring and shrinkage. Purpose: reduce tumor blood supply. Mechanism: heat-induced coagulation of tumor vessels PMC.Photodynamic Therapy (PDT)
A light-activated drug is injected, then activated with a low-power laser to produce reactive oxygen species that destroy tumor cells. Purpose: selective tumor cell killing. Mechanism: photosensitizer-mediated cytotoxicity.Cryotherapy
Extreme cold is applied via a probe to freeze and kill tumor cells. Purpose: destroy small, peripheral tumors. Mechanism: ice crystal formation disrupts cell membranes PMC.Transpupillary Thermotherapy (TTT)
Infrared laser heats the tumor through the pupil to 45–60 °C, inducing protein denaturation and cell death. Purpose: treat small to medium lesions. Mechanism: hyperthermia‐mediated coagulation of tumor tissue.Plaque Brachytherapy
A radioactive implant (“plaque”) is sutured to the sclera over the tumor for several days. Purpose: deliver localized radiation. Mechanism: ionizing radiation damages DNA in tumor cells ScienceDirect.External Beam Radiotherapy
Focused beams target the tumor from outside the eye. Purpose: treat larger or inaccessible lesions. Mechanism: radiation-induced DNA damage in dividing cells ScienceDirect.Proton Beam Therapy
Uses protons instead of photons for more precise dose deposition. Purpose: spare healthy retina. Mechanism: Bragg peak effect deposits energy primarily in tumor.Stereotactic Radiosurgery (Gamma Knife)
Delivers a high single dose of radiation from multiple angles. Purpose: treat small tumors in a single session. Mechanism: converging beams produce lethal dose at tumor.Fine Needle Aspiration Biopsy (FNA)
A tiny needle removes cells for diagnosis and may partially debulk small tumors. Mechanism: mechanical disruption and sampling.Endoresection
Surgical removal of tumor from inside the eye via vitrectomy instruments, typically after pre-operative radiation. Purpose: preserve the globe. Mechanism: mechanical excision of tumor tissue.Low-Vision Rehabilitation
Training with devices (magnifiers, telescopic lenses) to optimize remaining vision. Purpose: improve quality of life. Mechanism: adaptation and assistive devices.Psychological Counseling
Emotional support for coping with vision changes and treatment stress. Mechanism: mental health therapy to reduce anxiety and depression.Protective Eyewear
Sunglasses that block UV light may protect overall ocular health, though not specific to leiomyoma. Mechanism: UV filtration to reduce additional ocular damage.Occupational Therapy
Training to adjust tasks at work or home to compensate for visual deficits. Mechanism: skill re-training for daily activities.Support Group Participation
Connecting with others facing eye tumors for shared experiences. Mechanism: peer support reduces isolation.
Drug Treatments
Note: No drugs are specifically approved for intraocular leiomyoma; the following are off-label or inferential therapies based on uterine leiomyoma and ocular tumor literature.
Leuprolide Acetate (GnRH Agonist)
Class: Gonadotropin-Releasing Hormone (GnRH) agonist
Dosage & Time: 3.75 mg intramuscularly every 4 weeks for up to 24 weeks
Purpose: Shrink smooth muscle tumors by reducing estrogen levels
Mechanism: Downregulates pituitary GnRH receptors → decreased FSH/LH → hypoestrogenism PubMed
Side Effects: Hot flashes, bone density loss, vaginal dryness
Ulipristal Acetate
Class: Selective Progesterone Receptor Modulator (SPRM)
Dosage & Time: 5 mg orally once daily for 3 months (as per uterine fibroid use)
Purpose: Reduce tumor size and bleeding
Mechanism: Blocks progesterone receptors on smooth muscle cells Wikipedia
Side Effects: Headache, nausea, possible liver enzyme changes
Letrozole
Class: Aromatase inhibitor
Dosage & Time: 2.5 mg orally once daily for 3 months
Purpose: Lower estrogen production to inhibit tumor growth
Mechanism: Inhibits aromatase enzyme → reduced peripheral estrogen synthesis PMC
Side Effects: Bone loss, joint pain
Tamoxifen
Class: Selective Estrogen Receptor Modulator (SERM)
Dosage & Time: 20 mg orally once daily
Purpose: Block estrogen-driven proliferation
Mechanism: Antagonizes estrogen receptors in smooth muscle cells
Side Effects: Risk of blood clots, endometrial changes
Mifepristone
Class: Progesterone receptor antagonist
Dosage & Time: 10 mg orally once daily for up to 3 months
Purpose: Tumor shrinkage in hormone-dependent leiomyomas
Mechanism: Blocks progesterone signaling Nature
Side Effects: Fatigue, headache
Medroxyprogesterone Acetate
Class: Progestin
Dosage & Time: 10 mg orally once daily
Purpose: Modulate hormone environment
Mechanism: Alters estrogen/progesterone balance in target tissue
Side Effects: Weight gain, mood changes
Bevacizumab (Avastin)
Class: Anti-VEGF monoclonal antibody
Dosage & Time: 1.25 mg intravitreal injection once every 4–6 weeks
Purpose: Reduce tumor vascularity
Mechanism: Neutralizes VEGF → inhibits new blood vessel growth ResearchGate
Side Effects: Eye irritation, rare endophthalmitis
Ranibizumab (Lucentis)
Class: Anti-VEGF
Dosage & Time: 0.5 mg intravitreal monthly
Purpose & Mechanism: Similar to bevacizumab
Side Effects: Similar to bevacizumab
Pegaptanib (Macugen)
Class: Anti-VEGF aptamer
Dosage & Time: 0.3 mg intravitreal every 6 weeks
Purpose: Targeted VEGF inhibition in ocular tumors
Side Effects: Ocular discomfort
Interferon-α (IFN-α)
Class: Immunotherapy cytokine
Dosage & Time: 1 million IU intravitreal weekly for 4–6 weeks
Purpose: Anti-proliferative, immunomodulatory
Mechanism: Activates immune pathways to inhibit tumor cells
Side Effects: Intraocular inflammation, floaters
Dietary Molecular & Herbal Supplements
Based on uterine leiomyoma studies; no direct intraocular evidence exists.
Curcumin (Turmeric Extract)
Dosage: 500 mg twice daily
Function: Anti-proliferative
Mechanism: Activates PPARγ, induces apoptosis in leiomyoma cells PubMed
EGCG (Epigallocatechin Gallate, Green Tea Extract)
Dosage: 800 mg daily (45% EGCG)
Function: Anti-angiogenic, anti-fibrotic
Mechanism: Inhibits NF-κB & VEGF pathways PMC
Resveratrol
Vitamin D₃ (Cholecalciferol)
Dosage: 1,000 IU daily
Function: Hormone regulation
Mechanism: Low serum levels correlate with fibroid risk Wikipedia
Genistein (Soy Isoflavone)
Dosage: 50 mg twice daily
Function: Modulates estrogen receptors
Mechanism: Weak estrogenic/anti-estrogenic action
Indole-3-Carbinol (I3C)
Dosage: 200 mg daily
Function: Detoxification support
Mechanism: Modifies estrogen metabolism in liver
Diindolylmethane (DIM)
Dosage: 100 mg daily
Function: Estrogen balance
Mechanism: Promotes favorable estrogen metabolite ratios
Quercetin
Dosage: 500 mg daily
Function: Antioxidant, anti-inflammatory
Mechanism: Inhibits pro-inflammatory cytokines
Silymarin (Milk Thistle Extract)
Dosage: 200 mg twice daily
Function: Liver support, antioxidant
Mechanism: Scavenges free radicals
Lycopene
Dosage: 10 mg daily
Function: Antioxidant
Mechanism: Inhibits cell proliferation
Omega-3 Fatty Acids (Fish Oil)
Dosage: 1 g EPA/DHA daily
Function: Anti-inflammatory
Mechanism: Modulates eicosanoid pathways
Melatonin
Dosage: 3 mg nightly
Function: Antioxidant
Mechanism: Scavenges reactive oxygen species
Vitamin E (α-Tocopherol)
Dosage: 400 IU daily
Function: Antioxidant
Mechanism: Prevents lipid peroxidation
Selenium
Dosage: 200 µg daily
Function: Antioxidant enzyme cofactor
Mechanism: Supports glutathione peroxidase
Zinc
Dosage: 15 mg daily
Function: Immune support
Mechanism: Cofactor for many enzymes
Regenerative & Stem-Cell-Related Drugs
Sirolimus (Rapamycin)
Dosage: 2 mg orally once daily
Function: mTOR inhibitor, anti-proliferative
Mechanism: Blocks cell cycle progression
Everolimus
Dosage: 10 mg orally once daily
Function: mTOR inhibition
Mechanism: Similar to sirolimus
Temsirolimus
Dosage: 25 mg IV weekly
Function: mTOR inhibitor
Mechanism: Reduces protein synthesis in tumor cells
Interleukin-2 (Aldesleukin)
Dosage: 600,000 IU subcutaneously daily for 5 days
Function: Immune activation
Mechanism: Stimulates T-cell and NK cell proliferation
Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF)
Dosage: 250 µg/m² subcutaneously daily for 5 days
Function: Immune regeneration
Mechanism: Promotes maturation of immune cells
Autologous Mesenchymal Stem Cell (MSC) Injection
Dose: ~1×10⁶ cells intravitreal (investigational)
Function: Tissue repair, anti-inflammatory
Mechanism: Paracrine release of growth factors
Surgeries
Iris Iridectomy
Procedure: Partial removal of iris tissue where tumor is located
Why: Excise small iris leiomyomas while preserving eye integrity Nature.
Iridocyclectomy
Procedure: Removal of iris plus adjacent ciliary body tumor via scleral flap
Why: Remove medium-sized ciliary body leiomyoma while sparing globe BioMed Central.
Partial Lamellar Sclerouvectomy
Procedure: Scleral flap and removal of choroidal/ciliary tumor
Why: Excise deep uveal tumor while maintaining globe.
Endoresection
Procedure: Vitreoretinal surgery to resect tumor from inside the eye
Why: Globe-salvage approach for select choroidal tumors.
Enucleation
Procedure: Complete removal of the eyeball
Why: Indicated for very large tumors, uncertain diagnosis, or when vision cannot be preserved Nature.
Prevention Strategies
Note: No specific prevention is known due to unclear causes EyeWiki. These general eye-health measures may help:
Regular comprehensive eye exams
UV-blocking sunglasses
Healthy weight maintenance
Balanced diet rich in fruits and vegetables
Vitamin D sufficiency (≥30 ng/mL serum level)
Antioxidant-rich foods (berries, green tea)
Avoidance of smoking and excessive alcohol
Control of systemic conditions (hypertension, diabetes)
Stress management and sleep hygiene
Protective eyewear during sports or hazardous work
When to See a Doctor
New, unexplained change in eye color or shape of pupil
Blurred vision, visual field loss, or flashes of light
A visible white or yellow mass in the iris or pupil
Eye pain or discomfort not explained by dry eye
Redness or inflammation around the tumor
Sudden increase in floaters
Raised intraocular pressure (detected on exam)
Significant tumor growth on monitoring
Suspected spread to surrounding structures
Planning treatment consultation for tumor management
Foods to Eat and Avoid
Eat:
Leafy greens (spinach, kale) – antioxidants EatingWell
Berries (blueberries, strawberries) – flavonoids
Nuts (almonds, walnuts) – healthy fats
Fatty fish (salmon, mackerel) – omega-3s
Green tea – EGCG PMC
Turmeric-seasoned dishes – curcumin PubMed
Citrus fruits – vitamin C
Beans and legumes – fiber, phytoestrogens
Whole grains – stable blood sugar
Low-fat dairy or fortified plant milks – vitamin D
Avoid:
Red and processed meats – pro-inflammatory EatingWell
Excessive caffeine – may affect hormone balance
Alcohol – oxidative stress
High-fat dairy – unclear effects on smooth muscle tumors
Refined sugars – feed inflammation
Trans fats (fried foods) – inflammation
Excess salt – may worsen pressure changes in eye
Smoking – vascular damage
Artificial additives – potential endocrine disruptors
Plastics with phthalates – possible hormonal effects
Frequently Asked Questions
What is an intraocular leiomyoma?
A benign smooth muscle tumor inside the eye, often in the iris or ciliary body PubMed.How common is it?
Extremely rare—around 80 reported cases in the literature ResearchGate.What causes it?
Unknown; may arise sporadically from uveal smooth muscle or vessel walls WebEye.Is it cancerous?
No, it is benign and does not metastasize.How is it diagnosed?
Eye exams with slit lamp, ultrasound biomicroscopy, OCT, and often biopsy with immunohistochemistry WebEye.What are the symptoms?
Blurred vision, visible pupil mass, ocular discomfort, sometimes none.Can it turn into melanoma?
No, but it can mimic melanoma clinically, so biopsy is important ScienceDirect.What imaging tests are used?
Ultrasound, OCT, fundus photography, fluorescein angiography.What is the first-line treatment?
Depends on size/location—small asymptomatic tumors often monitored; others treated with laser, radiation, or surgery PMC.Is surgery always needed?
Not always—many can be managed non-surgically if small and stable.What are the risks of treatment?
Vision loss, cataract, glaucoma, inflammation, but many treatments spare the globe.Can it recur?
Recurrence is rare if completely excised.Are there known preventive measures?
None specific; general eye health measures recommended EyeWiki.What is the prognosis?
Excellent if managed appropriately; most patients retain vision and avoid eye removal.Where can I get more information?
Consult an ocular oncologist; resources include EyeWiki and peer-reviewed ophthalmology journals EyeWiki.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: August 07, 2025.
