More than two dozen types of cancer can develop in the various structures in and around the eye. These include subtypes of melanoma, lymphoma, sarcoma, and carcinoma.
The eye and its surrounding area are composed of several key structures where cancer may develop:
Internal structures like the uvea, retina, and vitreous.
The middle layer of the eyeball, comprising:
The gel-like fluid that fills the main part of the eyeball.
The light-sensitive cell layer at the back of the eye, connected to the brain by the optic nerve.
The bony space around and behind the eye, containing important nerves (including the optic nerve), the lacrimal gland, and eye-moving muscles.
Located in the upper outer quadrant of the orbit, this gland produces tears.
Tumours can affect the skin or the inner layer (tarsus and conjunctiva).
The surface covering of the eye that also covers the inside of the eyelid.
The structure responsible for draining tears, located near the nose in the inner lower quadrant of the orbit.
Eye cancers are categorised by their primary location:
Note: Non-cancerous growths like Circumscribed choroidal hemangioma and Retinal hemangioblastoma may also occur in the eye structures.
Note: Non-cancerous tumours like Orbital and optic nerve meningiomas and Pleomorphic adenoma (of the lacrimal gland) also occur.
Cancer of the white blood cells that can affect the vitreous, choroid, conjunctiva, or adnexa (surrounding structures). Types include Diffuse large B-cell lymphoma and indolent lymphomas like Marginal zone lymphoma and Follicular lymphoma.
Factors that may increase the risk of developing eye cancer include:
In the early stages, eye cancer often has no symptoms. When signs do appear, they can vary and may include:
Loss of vision, blurry or double vision, flashing lights, or floaters (objects in the field of vision).
Orbital or ocular pain, excessive or bloody tears.
Important: These symptoms may signal other health problems and should always be discussed with a doctor.
Patients with suspected eye cancer should consult an ophthalmologist (a medical doctor specialising in the eye) who has specific training in diagnosing eye cancers. Diagnosis involves several tests and exams:
A dilated retinal exam and ultrasound imaging for tumours of the eyeball, and a careful inspection of the outside of the eye and eye movements for orbital, eyelid, and conjunctival tumours.
Used to identify the location, size, and shape of the suspected tissue. These include:
The removal of a small tissue sample for microscopic examination. Biopsies are used in limited circumstances to diagnose eye cancer and may require local or general anaesthesia depending on the tumour's location.
Used to look for specific mutations in tumour cells to assess the risk of metastasis or to plan treatment. Genetic testing can also determine if the patient has an inherited form of eye cancer.
Performed to monitor the body's response to ongoing treatment.
The treatment of ocular cancers is highly specialised. At SSCHRC, care is personalised to include the most advanced therapies while minimising the impact on the body. Our primary goals are successful treatment, preserving the eye and vision whenever possible, and restoring the patient's appearance after treatment.
Treatment options are determined based on several factors, including: the type of cancer, its location and size, whether it has spread (metastasised), and the patient's age and overall health.
One or more of the following therapies may be recommended:
Uses focused beams of energy to kill cancer cells, precisely targeting the tumour to minimise damage to healthy tissue. Types offered include:
Drugs used to kill cancer cells or control their growth. It can be delivered in several ways:
Topical chemotherapy in the form of eye drops is also used for some cancers (e.g., sebaceous carcinoma, conjunctival squamous cell carcinoma).
Drugs designed to interfere with the specific molecules that cancer cells need to survive, multiply, and spread. This is used for eye cancer that has spread to other parts of the body.
Therapy to improve the immune system's ability to fight cancer, also used for eye cancer that has spread. Types include:
Uses an intense, focused beam of light to destroy cancer tissue, sometimes used for uveal melanoma and metastatic tumours inside the eyeball.
Uses extreme cold (freezing) to destroy cancerous tissue. It is sometimes performed as an outpatient procedure.