What Is Eye Cancer?

Overview

Have you ever heard of eye cancer? While you may be familiar with lung cancer, leukaemia, and brain cancer - eye cancer is often overlooked. It occurs when cancer cells grow uncontrollably in the eye or the tissue surrounding the eyeballs, and it can spread to other parts of the body, such as the lungs or breasts.  Eye cancer is a type of malignancy that starts in a group of abnormal cells in the eye. In this article, we will discuss the different types of eye cancer, their  stages, causes, signs and symptoms, management and treatment, diagnosis, and risk factors.

Types of eye cancer

Different types of eye cancer can T affect the eye, such as eye melanoma, squamous cell carcinoma, lymphoma, and retinoblastoma - a childhood cancer. Eye cancer can be classified based on where it starts, its location, and the types of cells involved.

One type of eye cancer is intraocular melanoma, which arises from melanocytes. Melanomas are the most common type of eye cancer, and uveal melanomas start in the middle part of the eye called the uvea.

Eyelid and orbital cancer develop in the tissue near the eyeball, specifically in the orbit, muscles, nerves, or other tissues that move the eyeballs. Adnexal cancer, on the other hand, forms in supporting tissues such as the eyelid and tear glands.

Retinoblastoma is a type of eye cancer that forms in the retina at the back of the eye. This cancer is more common among children under the age of five.

Intraocular lymphoma is a rare type of B-cell lymphoma that forms in white blood cells called lymphocytes. It is more common among people over the age of 50 or those with a weakened immune system.

Stages of eye cancer

The Surveillance, Epidemiology, and End Results (SEER) database maintained by the National Cancer Institute provides survival statistics for various types of cancer. Unlike other staging systems that use Stage 1, Stage 2, Stage 3, etc., the SEER database groups cancer stages as localized, regional, or distant.  Cancer  is considered to be in the localised  stage when there is no evidence that it has spread outside the eye. On the other hand, cancer is classified as regional when it has spread beyond the eye to nearby structures and lymph nodes. Finally, cancer is considered to be in the distant stage when it has spread to distant parts of the body, such as the liver.

Causes of eye cancer

The exact causes of eye cancer are still not known, however, scientists have found that eye cancer is linked to some conditions that are considered risk factors of the cancer.

Research is currently underway to investigate various DNA mutations and their potential role in the development of eye cancer. Despite ongoing efforts, it is not yet fully understood why certain individuals may experience these genetic alterations while others do not.

Signs and symptoms of eye cancer

Eye cancer is often undetected by individuals until a medical professional such as an optometrist or ophthalmologist identifies something unusual during an eye examination. This could include enlarged blood vessels or a dark spot which may indicate eye cancer or another eye-related problem. It is crucial to undergo testing to confirm any suspicions.

Eye cancer may not always exhibit obvious symptoms and can sometimes only be detected through a routine eye examination. Signs of eye cancer can involve a variety of symptoms, such as shadows, flashes of light, or distorted lines in your vision, blurred vision, a dark spot in your eye that's enlarging, partial or complete loss of vision, bulging of one eye, a growth on your eyelid or in your eye that's increasing in size, persistent eye irritation, and rare cases of pain in or around your eye. However, these symptoms may also be associated with less severe eye disorders, which means they do not necessarily indicate cancer. Nevertheless, it's crucial to have the symptoms checked by a physician as quickly as possible.

Management and treatment for eye cancer

If the diagnosis is uncertain or if the tumors grow slowly, your healthcare provider might suggest monitoring your condition and postponing treatment. This is especially true if the risks associated with treatment outweigh the potential benefits. For instance, you may prefer to hold off on treatment if treating a specific area could result in loss of vision.

There are several treatment methods for eye cancer. Radiation therapy is the most commonly used method. Surgery is also a common treatment for localized cases of eye cancer. Laser therapy is a method that uses heat to destroy cancerous cells in the eye. Immunotherapy is another method that helps the immune system identify and destroy cancer cells more effectively. Targeted therapy uses drugs to target the weaknesses in cancer cells and destroy them. Finally, chemotherapy is an uncommon treatment for eye cancer.

Diagnosis of eye cancer

Ophthalmologists play a crucial role in diagnosing and treating orbital metastases, as up to 35% of patients with these metastases have no known history of primary tumors. Metastatic tumors can be detected through history-taking  and symptoms such as pain, diplopia, and proptosis. CT scans, specific tests, and biopsies can help diagnose these tumors.¹

Risk factors

Eye cancer risk factors include race/ethnicity, eye color, age, gender, certain inherited conditions, moles, and family history. While some risk factors like smoking can be changed, others such as age and genetics cannot. Having known risk factors does not necessarily mean a person will get the disease. Studies on unproven risk factors such as sun exposure and certain occupations are still ongoing.

FAQs

How can I prevent eye cancer

Screening can improve your prognosis for eye cancer, but prevention is not possible. 

Is eye cancer curable

Factors like tumor size, location, and spread determine the treatment outcome and prognosis. Brachytherapy can remove 95% of small and medium intraocular melanomas. While not curable, eye cancer can be contained within the eye.

How common is eye cancer

Eye cancer is rare with a yearly diagnosis of approximately 850 cases in the UK.

When should I see a doctor

High-risk individuals, such as those with BAP1 tumor predisposition syndrome or a family history of retinoblastoma, should consider regular eye exams to detect cancer early.

Summary

Eye cancer, often overlooked compared to other types of cancer, is a malignancy that starts from abnormal cells in or around the eye, with different types including eye melanoma, squamous cell carcinoma, lymphoma, and retinoblastoma. Symptoms include bulging or growth of an eye or eyelid, dark spots, pain, or blurred vision. There are various treatment methods, including radiation therapy, surgery, laser therapy, immunotherapy, targeted therapy, and chemotherapy. Eye color, race/ethnicity, age, gender, certain inherited conditions, moles, and family history are all considered risk factors, with regular eye exams important for early detection.