Published on Sep 22, 2018 and last reviewed on Dec 20, 2022 - 3 min read
Cancer is a leading cause of mortality and morbidity in the developed world and is on the rise among 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. This article looks at the main cancers of the eye and has been written to be a basic guide to the common man about what important symptoms s/he will need to be concerned about and those problems that would need an immediate consultation with an ophthalmologist.
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. This article looks at the main cancers of the eye and has been written to be a basic guide to the common man about what important symptoms s/he will need to be concerned about and those problems that would need an immediate consultation with an ophthalmologist.
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 excision biopsy procedure.
2. Ocular Surface Squamous Neoplasia
It is a disease cohort involving many stages of 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 a pricking pain. The main mode of diagnosis is by clinical examination and they are treated surgically by excision biopsy.
3. 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 healing over many months need 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.
4. Malignant Melanoma
This is one 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 chemo and radiation therapy.
It 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, 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.
It is the commonest intraocular tumor of childhood and presents with more or less the same features and signs of 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.
Keeping the above points in mind, given below are a few take home points regarding when to seek help and a few preventive measures.
When to Visit an Ophthalmologist
1. When there is a mole, growth, wound, bleeding point or discolored patch that shows features of growth over a short span of time such as few days. If the growth pattern is marginal over years, then such lesions can be assumed to be less dangerous.
2. When there is asymmetry of the border of the lesion, that is, the lesion does not appear as a round mole or has an angular appearance of the edges.
3. When there are swellings in the neck, jaw, in front of, or behind the ear, these can be lymph nodes. They are characteristic of malignant tumors and indicate a grave sign that there is a spread of cancer to other parts of the body.
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).
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.
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.
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.
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.
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.
The symptoms of eye lymphoma are as follows:
- Dry eyes.
- Blurred vision.
- Discomfort and eye irritation.
- Redness in the eyes.
- Sensitivity to light.
- Floaters or lines or tiny dots in the field of vision.
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).
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.
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.
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.
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.
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.
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.
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
Last reviewed at:
20 Dec 2022 - 3 min read
I got a new birthmark like thing. Is it melanoma?
Query: Hi doctor, I have a birthmark like thing on one of my toes. I am 90 percent sure that I have not had it since birth. My father passed away due to melanoma. I am much worried about this. Please help me. Read Full »
Retinoblastoma - Causes, Complications, Prevention, Diagnosis, Treatment
Article Overview: Retinoblastoma is a tumor of the eye and is more common in children. This article explains this condition in detail. Read Article
Introduction Retinoblastoma is a type of cancer that affects the eye and initiates in the retina, which is the lining present within the eye. It is a sensitive part of the inner eye. This type of cancer affects kids more commonly but is rarely known to occur in adults. The function of the retina is ... Read Article
Most Popular Articles
Do you have a question on Eye Irritation or Malignant Melanoma?Ask a Doctor Online