Eye cancer

What is eye cancer?

Eye cancer, otherwise referred to as ocular oncology, encompass all forms of cancer that affect the eyelids, eyes and eye orbit. These tumours can be benign or malignant. In most cases they are benign, but tumours can grow larger over time and cause eye problems due to the compression of other structures in the area.

The main intraocular tumours include:

  • Ocular melanoma
  • Retinoblastoma , occurs in childhood
  • Choroidal haemangioma
  • Orbital tumours

Prognosis:

Each type form of eye cancer has a different prognosis:

  • Intraocular tumours, including melanoma, may occur in several tissues. However, the most common primary malignant intraocular tumours in adults are those that occur in the choroidal location (choroidal melanoma).
  • Retinoblastoma is an aggressive cancer, so early diagnosis and treatment is essential. Choroidal haemangioma, on the other hand, is benign but spreads rapidly and can alter vision, as its growth threatens the optic nerve.
  • Orbital tumours are the least common and have no specific causes.

Symptoms of eye cancer:

Most eye tumours are usually asymptomatic and may initially go unnoticed. Eyelid tumours, however, manifest as lumps or lesions that cause ocular discomfort; while orbital tumours manifest as ocular pain or alterations, decreased vision or displacement of the ocular globe (proptosis or exophthalmos).

One of the most characteristic symptoms of an orbital tumour is exophthalmos, i.e. bulging eyes. Eye movement can also be affected and may result in double vision.

Tumours that affect the optic nerve may alter vision more quickly. Pain is a less frequent and a more typical symptom of inflammation and/or orbital infections.

Changes may occur in the eyelids, such as swelling of the eyelid (oedema) or redness of the eyelid (erythema), which are typical of infectious and/or inflammatory processes and some tumours. The eyelid may also be more retracted, as in the case of thyroid ophthalmopathy, or more drooping (palpebral ptosis).

Medical tests for eye cancer:

An ophthalmologic examination using an ophthalmoscope may reveal a simple oval or round lump (tumour) in the eye.

Tests that may be performed include:

  • CT scan or MRI scan of the brain, to check for spread of the disease (metastasis) to the brain
  • Ultrasound of the eye
  • Skin biopsy, if an area of skin is affected.

What causes eye cancer?

Some tumours are congenital, such as 50% of retinoblastomas, and are passed from generation to generation, affecting 1 in 15,000 newborns.

Others, such as intraocular melanomas, have no specific risk factors. Some may be associated with a syndrome or may be secondary tumours due to spreading from adjacent areas or the result of metastasis.

Can eye cancer be prevented?

Intraocular tumours cannot be prevented, but they can be diagnosed early.

You should therefore have a routine annual examination of the eyes from the age of 50, when they are most likely to appear.

In addition, since malignant lesions can recur over time, regular monitoring is important following treatment.

Treatments for eye cancer:

Treatment depends on the type of tumour and its location within the orbit.

Benign tumours are usually monitored with regular check-ups and routine imaging tests, unless they cause vision loss or other problems involving the eyeball, in which case treatment would entail surgical removal of the tumours.

Malignant tumours will usually be removed completely. Surgery for these tumours is delicate and is performed by making small incisions in the skin of the eyelid (in the natural folds of the eyelid) or through the conjunctiva. Only very rarely does treatment involve the loss of the eyeball and all the structures of the orbit (orbital exenteration).

In other cases, treatment is systemic, based on with radiotherapy and/or chemotherapy.

Each case must be assessed on an individual basis in order to make the most appropriate decision.

Which specialist treats eye cancer?

All eye tumours require early and thorough evaluation by an ophthalmologist.