17292 Eye Cancer

Overview

Eye cancer is a rare disease in which abnormal cells grow in or around the eye. These cells can form a tumor. Eye cancer can start inside the eyeball, in the colored part of the eye, or on the outer surface. With early diagnosis and treatment, many eye cancers can be managed successfully.

No. Eye cancer is rare. Only a small number of people are diagnosed each year around the world.

Eye cancer can affect anyone at any age. Certain types, such as retinoblastoma, usually affect young children. Other types, like melanoma of the eye, are more likely to affect adults older than 50. It is slightly more likely to occur in people with light-colored eyes or a family history of eye cancer.

Symptoms

Common symptoms

• Blurred vision or changes in how well you see
• A dark spot on the iris (the colored part of the eye)
• A change in the shape or size of the pupil
• Seeing flashes of light, wavy lines, or floating specks
• A red, painful eye that does not settle
• An eye that bulges outward or feels full

Symptoms in children

• A white or yellow glow in the pupil that catches the light (looks a bit like a cat's eye)
• A squint or eyes that point in different directions
• Poor vision or a lazy eye that is getting worse
• Redness, puffiness, or swelling around the eye

Symptoms in older adults

• Gradual changes in vision that are not typical for their age
• New spots, floaters, or flashes that persist
• Redness or pain in one eye
• A feeling that the eye is 'heavy' or swollen

Causes

Main causes

• The exact cause of eye cancer is not known in most cases. It happens when the genetic material inside cells in the eye changes, causing the cells to multiply too quickly.
• In some cases, children inherit a specific gene change from a parent that greatly increases their chance of developing retinoblastoma, a type of eye cancer seen in young children.

Risk factors

• A family history of eye cancer
• Inherited conditions that raise the risk of certain cancers
• Having light-colored eyes or many moles in the eye
• Being over 50 (for some types of eye cancer)
• Long-term sun exposure may increase the risk of some eye surface cancers

When to see a doctor

See a doctor urgently if:

• Go to your doctor or eye clinic the same day if you notice any sudden change in your vision, such as a dark curtain or shadow, or if you see a sudden burst of flashing lights.
• Seek same-day help if you see a new dark spot on the iris, or if your child has a white glow in the pupil.

Book a routine appointment if:

• If you notice gradual vision changes, wear new or worsening floaters, or simply have concerns about a mole in your eye, book an eye exam with an optometrist or your general practitioner (GP).
• If you have a family history of eye cancer, ask your doctor how often you should be checked.

Diagnosis

To diagnose eye cancer, an eye specialist (ophthalmologist) will examine your eye with special lights and magnification. They may also use imaging scans to see the inside of the eye in detail. If something looks unusual, they may take a small tissue sample (biopsy) to check for cancer cells.

Tests that may be done

• A dilated eye exam using special eye drops to widen your pupil so the back of the eye can be seen
• Ultrasound of the eye, which uses sound waves to create an image of the internal structures
• Optical coherence tomography (OCT), a quick scanning test that takes cross-section pictures of the retina
• Fluorescein angiography, a test that uses a harmless dye to highlight blood vessels in the eye
• A biopsy, where a small piece of tissue is removed and looked at under a microscope

What to expect at your appointment

The doctor will explain the findings and, if needed, refer you to a specialist eye cancer team. You may need more imaging tests to see whether the disease has spread. It is normal to feel anxious while waiting for results. Ask your healthcare team any questions you have, and bring a family member or friend for support.

Treatment

Treatment for eye cancer is personalized. The plan depends on the type of tumor, its size and location, whether it has spread, and your overall health. The main aims are to control the cancer, save your sight where possible, and keep you well.

Self-care at home

• Attend every appointment so your care team can monitor the eye closely.
• Wear UV-protective sunglasses and a wide-brimmed hat when in strong sunlight.
• Tell your doctor right away about any new eye symptoms, such as pain, redness, or vision changes.
• Take care of your general health by eating well, resting, and talking openly about your worries.

Medical treatments

Medical treatments may include radiation therapy, which uses tightly focused beams of high-energy rays to destroy cancer cells while trying to protect normal eye tissue. Laser treatment or photodynamic therapy (a light-activated treatment) can also be used for small tumors. Chemotherapy, which is a medicine that travels through the body to kill cancer cells, may be used for certain eye cancers, especially in children. Biological or targeted therapies may be offered in specific situations. Your specialist will explain which approach is appropriate and why.

When is surgery considered?

Surgery may involve removing only the tumor and a small edge of healthy tissue. If the cancer is very large or has entered other parts of the eye, the whole eyeball may need to be removed (a procedure called enucleation). This is only done when there is no safer way to control the disease, and measures can be taken to fit an artificial eye for appearance.

Living with this condition

After treatment, you will have regular check-ups for many years. Some people lose some sight, while others keep most of their vision. Your team will help you adapt to any changes and connect you with low-vision services if needed. It can help to plan your daily tasks so you have energy and ensure someone goes with you to important appointments.

Lifestyle tips

• Use UV-protective sunglasses and a hat when outside.
• If you smoke, ask your practice nurse or general practitioner for support to stop.
• Keep active in ways you enjoy, and get plenty of rest.
• Stay in contact with friends and family rather than avoiding your feelings.

Diet and exercise

There is no special diet that will cure eye cancer, but a nourishing, balanced diet can help you maintain strength and recover better. Try to include fruits, vegetables, whole grains, and protein in your meals. Gentle exercise, such as walking, can improve your mood and energy. Always check with your doctor if you are unsure how much exercise to do.

Mental health and emotional wellbeing

A diagnosis of eye cancer can be frightening and may bring up anxiety, sadness, or stress. These feelings are completely understandable. Talk to your oncology nurse, general practitioner, or social worker about how you are feeling. Some people find counseling or talking therapies helpful. You are allowed to ask for help.

Prevention

Most eye cancers cannot be prevented because they happen due to cell changes that are not in your control. However, you can reduce your risk of some eye problems by wearing UV-protective sunglasses and a hat outdoors, and by having routine eye tests. If you have a family history of eye cancer, ask your doctor about genetic counseling and regular eye exams.

Vaccines

There is currently no vaccine to prevent eye cancer.

Screening programmes

Routine eye examinations can sometimes spot eye cancer in its early stage before it causes symptoms. People with a known family history of inherited eye cancer may be offered specialised screening, which can be lifesaving.

Complications

If left untreated

• If left untreated, eye cancer can grow and slowly destroy the structures of the eye, causing pain and loss of vision.
• The cancer can also spread to other parts of the body, most often the liver, which seriously threatens health.
• A delayed diagnosis means treatment becomes harder and the chance of success may be lower.

Long-term outlook

Outlook for eye cancer is better today than it has ever been, especially when the tumor is found early. Many people are treated successfully and continue to live full lives. Your specialist will be able to give you more personal information based on your exact situation.

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