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.
