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Eye Cancer

Eye cancer is the uncontrolled growth of abnormal cells that become a mass (tumor) in or around the eye. Secondary eye cancer (the type where the cancer starts elsewhere in the body and metastasizes to the eye) is more common than primary eye cancer (the cancer starts in the tissues of the eye). Breast cancer and lung cancer are the most common types of cancer that can cause secondary eye cancer.

Eyelash; The eyeball consists of three main parts: the orbit (eye socket, muscles and nerves surrounding the eye socket) and adnexal structures (accessory structures such as the eyelid and tear ducts). Primary eye cancers can develop in any of these three parts. When cancer starts in the eyeball, it is called primary intraocular cancer. The most common form of primary intraocular cancer in adults is melanoma, followed by lymphoma.​Primary intraocular cancer types and typical locations are described below:Melanomas develop in pigment-producing or color-producing cells, such as those in the iris of the eye.Retinoblastomas begin in the retina (the light-sensitive tissue at the back of the eye). Retinoblastomas are the most common form of primary intraocular cancer in children. When primary orbital or adnexal cancers occur in specific areas, such as the eye socket or eyelid, they take the form of cancer of the bone, muscle, nerve, or skin.​While primary eye cancer can occur in both men and women at any age, it is more common in certain age groups. That is, primary eye cancers are most common in people older than 50 years of age. Retinoblastoma is most common in children younger than five years old. Two-thirds of retinoblastoma cases occur in children younger than two years old. The exact cause of most primary eye cancers is unknown; but retinoblastoma is the exception. Because retinoblastoma can also develop as an inherited form (passed from parent to child through a gene). Indeed, the hereditary form of retinoblastoma accounts for about 25 percent to 30 percent of cases.


What is eye cancer?


​Eye cancer is a rare tumor that can affect the outer parts of the eye (such as the eyelid) or the inside of the eyeball (intraocular cancer). While the most common intraocular cancers in adults are melanoma and lymphoma, the most common in children is retinoblastoma, which starts in retinal cells. Eye cancer develops when abnormal cells in the eye grow and divide uncontrollably. Regular eye exams offer the best chance of detecting eye cancer at its earliest, most curable stage.


What causes eye cancer? What are the risk factors for eye cancer?


Although the exact cause of eye cancer is not known, there are some factors that can increase the risk of eye cancer, such as the following.

  • having lighter colored eyes

  • Progression of age (people over 50)

  • Too many moles on the skin

  • People with a first-degree relative with eye cancer

  • weakened immune system

  • Inherited conditions of pigment-producing cells, such as dysplastic nevus syndrome and oculodermal melanocytosis (also called nevus of Ota)

  • Caucasian race: Has a higher risk of eye melanoma than people of other races.

Retinoblastoma in children is an inherited or genetically linked condition in about 25 percent to 30 percent of cases, due to a mutation in the retinoblastoma gene (RB1). The hereditary form of retinoblastoma tends to occur at a younger age and is more likely to affect both eyes compared to the non-hereditary form.


On the other hand, ultraviolet (UV) light from sunlight has also been suggested as a possible risk factor for eye melanoma; but this has not been proven. There is a known link between sun exposure and the development of melanoma. This may include intraocular melanomas, although not yet proven. That's why the American Cancer Society recommends using UV-protective sunglasses in addition to protective sunscreen and clothing when outside.


What are the symptoms of eye cancer?


People with eye cancer usually have no symptoms. Eye cancer is most often found during a routine eye exam. When symptoms do occur, painless vision loss most commonly occurs.Any of the symptoms listed below may also be associated with other medical conditions, so it is necessary to consult a healthcare professional for any changes in vision or other eye problems.


Some symptoms of eye cancer include:


  • Glaucoma (High intraocular pressure)

  • loss of field of viewvision loss

  • Eye swelling: swelling of one or both eyes (proptosis)see flashes of lightchange in iris color

  • Seeing dots, wavy lines, or floating objects

  • Mass in the front of the eye

Children with retinoblastoma may have the following symptoms:

  • Eyes seem to look in different directions

  • Eye pain or rednessPupils appear white instead of red in flash photos


While eye cancer is rare, it can cause life-threatening complications and death, especially if left undiagnosed and treated. Those with visual symptoms such as difficulty seeing, loss of part of the field of vision or flashes of light, dark spots on the iris, spots, wavy lines or floating objects should seek medical attention immediately.


How is eye cancer diagnosed?


There is no widely recommended screening for eye cancer, but annual eye exams (especially for those with identified risk factors) can play an important role in early detection. Eye cancers are often detected during routine examinations. Those diagnosed with primary eye cancer, where the cancer starts in the eye and has not spread, have a high survival rate.If the doctor suspects eye cancer, they may order imaging tests or an eye ultrasound to help with the diagnosis.Optical coherence tomography, also called eye tomography, is an imaging tool that illuminates retinal layers to assess the subtle presence of fluid, a sign of tumor activity. Magnetic resonance imaging (MRI) can also be helpful for diagnosis. In some cases, the doctor may do a fine needle biopsy to take a small sample of the tumor cells. The cytopathologist will analyze the sample to confirm the diagnosis within a few days.The doctor may also order other tests to see if the cancer has spread to other parts of the body.

Related tests may include:


  • blood tests to measure liver function

  • chest x-ray

  • Computed tomography (CT) scan

  • magnetic resonance imaging (MRI) scan

  • Abdominal ultrasound

  • Positron emission tomography (PET) scan


What are the treatment options for eye cancer?


Once diagnosed with eye cancer, the doctor will discuss the best options for treatment. The most appropriate treatment options for eye cancer depend on the following factors:


  • type of cancer

  • The location and size of the cancer

  • Whether the cancer has spread to other areas (Metastasis)

  • The patient's age and general health


A small eye melanoma may not require immediate treatment. Radiotherapy uses high-powered energy such as protons or gamma rays to kill cancer cells. Radiotherapy is typically used for some small eye melanomas and medium-sized eye melanomas. Laser therapy to kill melanoma cells may be an option in some cases. A type of laser treatment called thermotherapy uses an infrared laser. (Used in conjunction with radiation therapy in some cases)

In some small eye melanomas, cryotherapy can be used to destroy the melanoma cells. Chemotherapy is rarely used for eye melanoma; however, chemotherapy may be given for retinoblastoma and certain types of orbital lymphoma.


Surgical procedures in the treatment of eye cancer are as follows:

  • Eye-sparing surgery: It can generally be applied for eyelid cancers, conjunctival cancers and orbital cancers.

  • Iridectomy: The iris (the colored part of the eye) is removed.

  • Iridotrabeculectomy: The iris and a small part of the outer part of the eyeball are removed.

  • Eye reconstructive surgery: can often restore function after surgical removal of eyelid, conjunctival or orbital cancer,

  • Enucleation: To treat some types of eye cancer, the entire eye must be removed. This is only done in advanced cases, for intraocular tumors such as uveal melanoma or retinoblastoma.

  • Orbital exenteration: This surgical procedure; It involves removing the eye, eyelids, surrounding skin, orbital muscles, fat, and nerves. It is sometimes necessary for aggressive cancers of the orbit or sinuses, advanced or recurrent eyelid or conjunctival cancers.

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See Frequently Asked Questions here.

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