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Cancerous Conditions Related to the Eye

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Cancerous Conditions Related to the Eye

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Cancers of the eyes, although rare, required early diagnosis for an effective treatment outcome. Read to know more.

Medically reviewed by

Dr. Infanteena Marily F.

Published At September 22, 2018
Reviewed AtAugust 31, 2023

Introduction

Cancer is a leading cause of mortality and morbidity in the developed world and is on the rise amongst all age groups and social strata. The eye is also not spared from cancerous afflictions and has a whole plethora of cancerous and precancerous conditions that require proper evaluation and care by ophthalmologists.

It is unusual to develop eye cancer. In actuality, there are only approximately 3,500 brand-new cases every year, which is a small portion of the estimated more than 1.7 million new cases of cancer that are identified in the U.S. annually. Particularly if the cancer is small and not close to the eye's critical tissues, there are frequently no early symptoms or warning signals. Eye cancer is most effectively treated when it is found early. For that reason, it is always recommended that everyone have a dilated eye exam with an eye doctor once a year.

Eye cancer risk rises after the age of 50 and increases with age. People with light eyes and/or light hair are more likely to get eye cancer. Primary eye cancers are more common in males than in women; according to the American Cancer Society, roughly 2,130 men are diagnosed with eye cancer each year, compared to 1,410 women.

According to certain research, there may be a minor risk of uveal melanoma among welders. Although the precise cause is uncertain, UV light from welding equipment is thought to be likely to be responsible for other environmental factors.

What Are the Cancerous Conditions Affecting the Eyes?

The majority of malignancies that affect the eye don't begin there. These malignancies, however, start elsewhere in the body, most frequently in the lungs and breasts, and then travel to the eye, most frequently to the uvea. Melanoma can also form on the eyelid, however, this is considered skin cancer rather than intraocular cancer and has different characteristics. Since the lower lid is more likely to be exposed to sunlight than the upper lid, is where most skin cancers on the eyelids (10 percent of all skin cancers) arise. Early detection and treatment of these tumors are crucial because they can spread and seriously impair eyesight.

The most commonly seen cancerous and precancerous conditions of the eyeball and eyelid include the following:

1. Primary Acquired Melanosis:

These are seen as brown spots or patches on the sclera (the white part of the eye). Patients are mostly asymptomatic and usually neglect their condition thinking that it is a simple birthmark. They are a forerunner to a notorious condition called malignant melanoma of the ocular surface described below. This condition, although not cancer by itself, has a high propensity to turn into one. Hence, it is very important to detect the case as early as possible. The diagnosis of this condition can be done by a simple torchlight or slit lamp examination by an ophthalmologist. It is treated by an excision biopsy procedure.

2. Ocular Surface Squamous Neoplasia

It is a disease cohort involving many stages of the disease of the ocular surface. It has varied presentations from a discolored patch to a bleeding or ulcerated growth. The lesion also can be relatively symptom-free but can give rise to symptoms like irritation or pricking pain. The main mode of diagnosis is by clinical examination and they are treated surgically by excision biopsy.

Basal Cell Carcinoma

It is most commonly seen in sun-exposed skin and hence is commonly seen on the face, especially on the lower lid. This condition mimics an open wound. So, any patient suffering from wounds on the face or lower lid, not resolved over many months needs to be especially suspected to be having this condition. The diagnosis is usually made clinically and treated by a surgical technique called Mohs micrographic technique. The condition may, very occasionally, spread to nearby structures and more rarely to far away viscera.

3. Malignant Melanoma

This is one of the more aggressive cancers of the ocular surface, which can spread to distant viscera. Its appearance is identical to a black mole on the sclera (the white of the eye) but can be identified as cancerous by the asymmetry of the borders and a gradual increase in size. The usual symptoms include pain and irritation. They are also treated by surgical excision and also by chemotherapy and radiation therapy.

4. Retinoblastoma

Retinoblastoma is one of the classical tumors known to have devastating effects on the vision of very young children. It is a tumor involving the immature retinal cells. It can present usually as leukocoria, that is, the central pupil of the eye becoming white. It can be picked up easily by parents. The other presentations can be less than adequate weight gain, and delayed milestones. Some cases can present frankly as a tumor growing on the eye, while some may push the eye out giving the appearance of prominent eyeballs. This condition needs a fundus examination to be diagnosed and needs investigations for staging and planning treatment. The risk of systemic spread must also be borne in mind.

5. Rhabdomyosarcoma

Rhabdomyosarcoma is the commonest intraocular tumor of childhood and presents with more or less the same features and signs as retinoblastoma. It is a tumor arising from the immature muscle cells of young children. It also can spread to other organs and needs to be treated surgically. It is usually seen in males.

What Are the Symptoms of Cancers of the Eyes?

Eye cancer symptoms may include:

  • Shadows, bright spots, or zigzag lines in the field of vision.
  • Clouded vision.
  • A growing black patch in the eye.
  • Partial or complete vision loss,
  • Bulging of one eye,
  • A mass on the eyelid or in the eye that is growing in size, persistent eye irritation, though this is uncommon.
  • Pain in or around the eye.

How Can Cancers of the Eyes Be Diagnosed?

An eye test to examine the structure of the eyes more closely and look for any anomalies include:

Visual Ultrasound Scan - The doctor can learn more about the location and size of the tumor by using a small probe put over the closed eye and using high-frequency sound waves to create an image of the eye. A fluorescein angiography, in which a dye is injected into the circulation to highlight the tumor and pictures of the probable cancer are obtained using a special camera. A tiny sample of tumor cells may occasionally be removed using a fine needle during a biopsy.

How Can Cancers of the Eyes Be Treated?

Eye cancers are typically treated with surgery to remove the tumor or a portion of the eye (this may be possible if the tumor is small and the individual still has some vision in the eye), brachytherapy (in which tiny plates lined with the removal of the eye) and enucleation - this may be necessary if the tumor is large or the patient has lost their eyesight or placement of radioactive material called plaques around the tumor and leaving them in place for up to a week to kill cancerous cells are other options. It is normal to feel anxious before having an operation on the eyes, but ophthalmologists frequently succeed in putting patients at ease. Less intrusive procedures are performed by using very small, delicate devices and numbing the eye.

Conclusion

Some preventive measures include avoiding excessive sun exposure, avoiding exposure to chemicals known to be carcinogenic and radiation. Cancerous conditions of the eyes are relatively rare. Although, it is crucial to diagnose any symptoms related to it early for an effective treatment outcome.

Frequently Asked Questions

1.

What Type of Cancer Can Affect the Eyes?

The various cancer types affecting the eyes are  
 -  Basal cell carcinomas (a type of skin cancer in the basal cells that produce new skin cells).
 - Primary acquired melanosis (a melanocytic lesion of the conjunctive).
 - Retinoblastoma (cancer occurring in the posterior part of the eye).
 - Ocular surface squamous cell carcinomas (cancer spread through metastasis in the corneal basement membrane of an eye).
 - Rhabdomyosarcoma (a soft tissue cancer).

2.

Which Is the Most Common Eye Cancer?

Melanoma is the most common type of eye cancer. Various other types of eye cancer affect multiple cells in the eyes. The most common is uveal melanoma in adults, which usually occurs in five percent of all melanoma cases.

3.

How Does Eye Cancer Develop?

Eye cancers develop due to errors in the eyes' deoxyribonucleic acids (DNA). These DNA errors cause uncontrollable growth and multiplication of the cells in the eyes. This further causes mutational cells not to die and keep living, accumulating in the eyes and forming eye cancer.

4.

Does Eye Test Detect Cancer?

An eye examination can detect various types of cancer in a patient. For example, cancers like leukemia and lymphomas can be seen by changes in the interior part of the eyes. In addition, skin cancers such as melanomas, basal cells, and squamous cells can be detected on the outer surface of the eyelids or eye.

5.

What Is the Survival Rate for Ocular Melanoma?

The survival rate for 82 percent of ocular melanoma patients is usually five years. If the melanoma does not spread outside the eyes, the survival rate can increase to 85 percent for five years. However, if the ocular melanoma has affected the patients' nearby organs, tissues, and lymph nodes, the survival rate can go down to 71 percent.

6.

Can We Get Cancer of the Eye Treated?

Doctors can treat eye cancer, but some cases are not treatable also. The radiation therapy used to treat eye cancers can also damage the eyes and cause various complications, such as vision loss. However, eye cancer treatment can prevent the spread and minimize the risk. Therefore, doctors initially recommend different treatment options other than radiation therapy.

7.

What Are the Various Symptoms of Eye Lymphoma?

The symptoms of eye lymphoma are as follows:
- Dry eyes.
- Swelling.
- Blurred vision.
- Discomfort and eye irritation.
- Redness in the eyes.
- Sensitivity to light.
- Floaters or lines or tiny dots in the field of vision.

8.

What Are the Two Common Types of Eye Cancer?

The two types of eye cancers are
- Squamous cell carcinoma (cancer of the eyelids).
- Eye melanomas (a type of cancer that develops in the melanin-producing cells).

9.

Can Eye Cancer Spread to the Brain?

Eye cancer can spread to a person's brain, optic nerve, and other body parts. Eye cancer can cause damage to a person’s vision and, thus, affect the brain's stimulation. Therefore early detection of eye tumors is critical to prevent their spread to other body parts.

10.

How Fast Is the Spread of Eye Melanoma?

Eye melanoma spreads in almost 50 percent of cases through metastasis (spread of cancer to different body parts). This very aggressive form of eye cancer can apply within two to three years after the diagnosis or many years after the treatment. Eye melanoma (a type of cancer that develops in the melanin-producing cells) can also spread to various other parts and therefore is considered fatal.

11.

Can Eye Melanoma Be Treated?

Melanoma of the eyes is a very aggressive cancer that the doctor removes through surgical excision, chemotherapy, or radiation therapy, depending on its size. In severe eye melanoma cases that have caused excessive damage to the eyeballs, enucleation or removal of the eyeball is the only treatment option.

12.

Are Melanomas of the Eye Life-Threatening?

Melanoma of the eyes is a very rare but life-threatening condition. These can cause damage to the eyes and lead to vision loss and retinal detachment if not diagnosed and treated promptly. In addition, the condition is life-threatening as these melanomas can spread to other body parts through metastasis in almost 50 percent of the cases causing fatal consequences.

13.

How Can We Get Cancer Of The Eyes Removed?

Eyes cancers can be removed with the following surgical options:
- Removal of the eyeball or enucleation.
- Removal of the ciliary body and iris of the eyes or iridocyclectomy.
- Removal of only a part of the iris or iridectomy.
-Removal of choroidal tumor only while keeping the eye, endoresection or sclerotomy.

14.

Is Eye Cancer Surgery Painful?

Eye cancer surgery is rarely painful unless the eye tumor is huge. However, the patient may experience pain in the initial weeks after surgery. Doctors usually manage this with painkillers to relieve these symptoms.

15.

How Is Biopsy for a Tumor Behind the Eye Done?

The biopsy of the eye is usually done under local anesthesia. First, a thin needle is used to remove the tissue samples. Next, the doctor inserts the needle in the eye, and the suspicious tissue sample is taken for a biopsy test. Then, a biopsy test is done in the laboratory to diagnose eye melanomas
Dr. Manjunath Natarajan
Dr. Manjunath Natarajan

Ophthalmology (Eye Care)

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