Eye Cancer

Cancer is made up of mutated cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas and they can spread to other parts of the body. This is called metastasis.

The eyes are organs that collect light and send it to the brain. The brain turns this light into pictures that let you see. The eye is made up of many different parts. Cancer can start in any part of the eye.

Primary eye cancer is a very rare kind of cancer that starts somewhere in or on the eye or in the skin of cells around the eye. It most often starts inside the eyeball itself. This is called intraocular cancer. Because it’s so rare, it’s best to seek treatment from an eye cancer specialist.

There are different kinds of eye cancers. Below are some of the more common ones:

• Intraocular melanoma (uveal melanoma). This is the most common type of primary eye cancer. It often develops in the choroid or ciliary body.

• Intraocular lymphoma. A very rare type of lymphoma (typically non-Hodgkin) that starts in the eyeball.

• Conjunctival tumors. These are tumors that grow on the surface of the eye. These tumors include squamous carcinomas, melanomas, and lymphomas.

• Retinoblastoma. This cancer of the eye is the most common type in children. It's extremely rare in adults.

The eye is an organ that collects light and sends it to the brain. The brain turns this light from the eye into pictures that let you see. The eye is made up of many different parts:

• Eyelids. These keep the eyes moist and shield them from light.

• Conjunctiva. This is a membrane that covers the eyeball and lets the eyelid slide easily over the eye without irritating it.

• Cornea. This is the clear window that helps focus light and covers and protects the iris.

• Iris. This is the colored part of the front of the eye. It adjusts the size of the opening in the middle of the iris (the pupil).

• Retina. This lines the inside of the eye. It does the work that helps people to see.

• Choroid. This is a layer of blood vessels under the retina. The choroid feeds the retina. It also has cells in it called melanocytes. These cells can sometimes grow into a cancer called melanoma.

• Ciliary body. This makes a watery fluid that is between the cornea and the iris. It also has muscles to control the shape of the eye lens. It does this to adjust to the distance of the objects you focus on.

• Uvea. This is a layer of tissue under the white of the eye (sclera). The uvea is made up of the choroid, the iris, and the ciliary body.

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. Risk factors can make it more likely for a person to have cancer. There are only a few factors known to increase the risk of eye cancer, and they aren’t under your control.

Talk with your healthcare provider about your risk factors for eye cancer and what you can do about them.

There’s no known way to prevent eye cancer, but regular eye examinations allows for early diagnosis and treatment. 

Are there screening tests for eye cancer?

There are no regular screening tests for eye cancer in people at average risk. Screening is done to check for disease in people who don’t have symptoms.

Eye exams are an important part of routine physicals and an eye doctor (ophthalmologist) should check for signs of cancer during regular eye exams.

If you have a lot of irregular moles on your body (dysplastic nevus syndrome), you may need to have your eyes checked more often. If you have a dark spot on your iris, see an eye doctor. If you have a mole in your eye (eye nevus), your eye doctor should check it regularly for changes.

Symptoms of eye cancer can include:

• Blurry vision that’s new.

• Partial or total vision loss.

• Seeing floating spots (floaters).

• Seeing flashes of light.

• Dark spots or shadows in your vision.

• A dark spot on your iris or other part of your eye.

• Sensitivity to light.

• A lump on your eyelid or other part of your eye.

• Change in the shape of your pupil (the pupil is the black center of the colored part of your eye).

• Bulging of an eye.

• Redness or swelling in the eye.

• Change in the way your eye moves.

• Pain in or around your eye.

Many of these may be caused by other health problems. But it is important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

You will need to see a specially trained eye doctor (ophthalmologist). The doctor will ask you about your health history, symptoms, risk factors, and family history of disease. He or she will do an eye exam. During the eye exam, the doctor will use a special scope with a light (ophthalmoscope) to look at the inside of your eye.

You may also have one or more of these tests:

• Ultrasound of your eye.

• Optical coherence tomography.

• Fundus photography.

• Fluorescein angiography.

• Biopsy.

Eye Cancer Staging

After a diagnosis of eye cancer, you’ll likely need other tests. These help your healthcare providers learn more about the cancer. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

Your treatment choices depend on the type of eye cancer you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and what the risks and side effects may be.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy is a systemic treatment. Chemotherapy can sometimes be given in the form of an injection into or around the eye. It can also be given as an eye drop. You may have one treatment or a combination of treatments.

Eye cancer can be treated with:

• Active surveillance or close monitoring.

• Surgery.

• Radiation.

• Laser therapy.

• Chemotherapy.

• Targeted therapy.

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, and vomiting. Other treatments, such as surgery or radiation, can affect your vision.

Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on the mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effects of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as redness or pain.

• Side effects of treatment that affect your daily function or don’t get better with treatment.

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.