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Eye cancer

Cancer within your eye is very rare. However, there are a few types of cancer that can cause a lump in or around your eye. Cancer is caused by an abnormal and uncontrolled growth of cells.

Cancer that develops in your eyeball is called intraocular cancer. There are several different types of intraocular eye cancer and all of them are very rare.

Cancer that develops around your eye is called extraocular cancer. Extraocular cancers are more common. They are more common in older people, particularly those who have had a lot of sun exposure during their lives.

Intraocular eye cancers

Eye cancers within the eye include the following.

  • Ocular melanoma (uveal melanoma). Melanoma is the most common type of eye cancer you can get in your eye if you’re an adult. It can affect the uvea of your eye, which is the front half of the eyeball.
  • Non-Hodgkin's lymphoma. This type of cancer usually develops in your lymph nodes. Lymph nodes are glands throughout your body that are part of your immune system. However, non-Hodgkin's lymphoma sometimes develops in your eye.
  • Retinoblastoma. This develops in the retina, which is at the back inner surface of your eye. It can affect one or both of your eyes. It’s often inherited and develops in young children, usually under fives. Over nine out of 10 children with retinoblastoma are cured with the right treatment.
  • Medulloepithelioma. This is a particularly rare eye cancer that can occur in the inner lining of your eye. It usually occurs in children.

Extraocular eye cancers

Eye cancers outside the eye include the following.

  • Ocular melanoma. This usually occurs in the eye, but it can also form on your eyelid or conjunctiva (the covering of your eyeball).
  • Other forms of skin cancers, such as basal cell carcinoma and squamous cell carcinoma, can develop near your eye. They usually don’t spread and can be cured.
  • Rhabdomyosarcoma. This is a particularly rare type of eye cancer that develops in the muscles that move your eye. It mostly affects children.
  • Optic nerve tumour. There are certain types of brain tumour that can develop in your optic nerve. This nerve connects your eye to your brain.

Secondary eye cancers

Sometimes, a cancer in another part of your body can spread and cause a new tumour in your eye. This is called a secondary cancer. This can happen in women with breast cancer, and in men with lung cancer.

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How cancer develops
Cells begin to grow in an uncontrolled way

Details

  • Symptoms Symptoms of eye cancer

    Symptoms of eye cancer vary depending on the type of cancer you have and where it's located.

    If you have an intraocular cancer, such as ocular melanoma, you might not have any symptoms. This type of cancer is sometimes detected in a routine eye examination.

    If you do have symptoms of eye cancer, they may include:

    • partial or complete loss of vision
    • blurred vision
    • seeing flashing lights, wiggles or spots
    • a change to the way your eye appears (such as a growing dark spot on the iris)
    • a lump or sore on your eyelid, possibly with crusting, bleeding or an ulcer
    • a bulging eye
    • pain in or around your eye (this is rare)

    These symptoms aren't always caused by eye cancer, but if you have any of them, see your GP or optician.

    If your child has retinoblastoma, you may notice their eyes are not quite aligned with each other. Or their pupil may look white, especially in photographs. Their eye may also be red and inflamed.

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  • Causes Causes of eye cancer

    The exact reasons why people develop eye cancer aren't fully understood. Some of the reasons why you may be more likely to develop eye cancer are listed below.

    • Having blue, grey or green eyes.
    • If you have unusual brown spots in your eye.
    • If you have lots of unusually shaped or large moles.
    • You go out in the sun too much without wearing skin or eye protection, such as sunglasses or a wide-brimmed hat.
    • A weakened immune system. People who have HIV/AIDS or who are taking medicines that suppress their immune system are more likely to develop some eye cancers.
  • Diagnosis Diagnosis of eye cancer

    Your GP or optician will ask about your symptoms and examine you. They may also ask you about your medical history.

    If your GP or optician thinks that you have intraocular eye cancer, they will refer you to an ophthalmologist. This is a doctor who specialises in eye health, including eye surgery. If your ophthalmologist thinks you have eye cancer, they may refer you to a specialist centre. There are only a few of these in the UK, so you may need to travel.

    You might have the following tests to confirm whether you have eye cancer.

    • Eye examination. Your doctor or optician will shine a light into your eye and look inside with special hand-held instruments. Your doctor may put drops into your eyes that can affect your vision for a short while.
    • Fluorescein angiogram. Your doctor will inject a dye into your arm that will travel through your bloodstream to the blood vessels in your eyes. This dye will show up on photographs so your doctor can look at the blood vessels in your eyes.
    • Ultrasound scan. Your doctor will move a small ultrasound sensor over your closed eyelids or on the skin around your eye. An ultrasound uses sound waves to produce an image of the inside of your eye.
    • CT or MRI scan. You may have one of these tests to check the muscle and tissues in and around your eye. A CT scan uses X-rays to make a three-dimensional image of your body. An MRI scan uses magnets and radiowaves to produce images of the inside of your body.
    • Biopsy. Using a fine needle, your doctor will take a sample of the fluid inside your eye or on the surface around your eye. This will be sent to a laboratory for testing.

    If your GP thinks you might have skin cancer around your eye, they may refer you to a dermatologist. A dermatologist is a doctor who specialises in skin conditions. See our skin cancer topic for more information.

  • Treatment Treatment of eye cancer

    Your treatment will depend on the type of eye cancer you have, its size, how far it’s spread, and your health. Your doctor will explain your treatment options and help you make choices. Feel free to ask any questions you have so you feel fully informed.

    There are three main treatments for eye cancer – surgery, radiotherapy and chemotherapy. If you have a type of skin cancer near your eye, have a look at our information on skin cancer.

    Surgery

    Surgery removes cancerous tissue. Sometimes only the tumour and a small amount of healthy eye tissue will need to be removed, such as your iris. However, you might need to have your whole eyeball removed, which is called enucleation surgery. If you have your eye removed, an artificial, or prosthetic, eyeball can be created to match your remaining eye.

    Some types of eye cancer, such as melanoma of the eye, can be treated with special laser therapy. This uses an infrared laser (beam of light) to destroy the cancer cells.

    Non-surgical treatments

    Radiotherapy

    Doctors sometimes use surgery and radiotherapy together to treat eye cancer. Radiotherapy uses radiation to destroy cancer cells. A beam of radiation is targeted at the cancerous cells, which shrinks the tumour. Sometimes, a source of radioactive material will be put in or near your tumour. This is called brachytherapy. Radiotherapy is often used to treat melanoma of the eye.

    The length of your radiotherapy treatment will depend on what type of eye cancer you have and how severe it is. If you have melanoma of the eye, you may have external beam radiotherapy as small doses over a few days, or brachytherapy for a week.

    Chemotherapy

    Chemotherapy is a treatment to destroy cancer cells with medicines. Chemotherapy can be effective for treating lymphoma of the eye and retinoblastoma. It's only used for melanoma of the eye if other types of treatment haven't worked.

    Chemotherapy is usually given into your vein using a drip. Sometimes it may be given as tablets.

    Side-effects are the unwanted effects of chemotherapy. They can include losing your hair, feeling sick, tired and having diarrhoea.

    Ask your doctor for information about the type and length of treatment you need and the side-effects you may have.

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  • How cancer develops How cancer develops

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    How cancer develops
  • FAQs FAQs

    Will eye cancer surgery change how I look?

    Answer

    How much eye surgery will affect your appearance depends on the type of surgery you have.

    Explanation

    Surgery for treating eye cancer can sometimes leave you with very little scarring. Other times it may remove part of or your entire eye. This is called enucleation.

    The amount of tissue your surgeon will remove depends in part on how far the cancer has spread. Advances in surgery and reconstruction mean that scarring is often less of a problem than it used to be. Over time, some scars can fade and become less noticeable.

    If your surgeon has to remove your whole eye, they will fit an artificial eye a few weeks later.

    Advances in eye surgery and prosthetics mean that artificial eyes can look very similar to real eyes and even have some movement. Your surgeon may also fit a permanent implant during your surgery. This is different to your artificial eye. An implant is designed to keep the right structure behind your eye to support your artificial eye properly.

    Have a chat with your doctor about your treatment options and how each one will affect your appearance.

    How will losing an eye affect me?

    Answer

    Having one eye may take some time to get used to. Sight changes can affect your ability to read, drive and do certain tasks. Losing an eye may also affect your confidence and interactions with others, especially at first.

    Explanation

    How much having your eye removed affects your life will depend on how much vision you had in the eye beforehand. If your vision was already poor because of your cancer, you may find it easier to adjust to having one eye. However, if you had full vision in the affected eye, it may take longer to adjust.

    The biggest change to your vision is likely to be to your perception of depth. At first, it will be difficult for you to tell how far away objects are from each other and from you. With time, you will adjust to this. For some people, losing an eye may also affect their balance.

    You may find that sight changes affect your ability to read, drive and do certain tasks.

    After having an eye removed, it can sometimes feel as if the eye is still there. You may see things that aren't really there, called visual hallucinations. This is a normal reaction and over time will stop happening.

    Losing your eye may affect your confidence and interactions with others, such as eye contact. You may feel angry, depressed or worried about your appearance. Over time, and with the help of others, these feelings are likely to improve.

    After your operation, allow yourself time to adjust. Take time off work and get used to everyday living. You might find it helpful to wear glasses or sunglasses at first if you’re concerned about your appearance.

    Can I drive if I lose an eye?

    Answer

    Often, yes, but it depends on your vision in the remaining eye. You will need to wait until you have adjusted to seeing with only one eye before driving.

    Explanation

    If you’ve had an eye removed, you will find it harder to tell how far away objects are from each other and from you (your depth perception). This may affect your driving. You will need to inform the Driver and Vehicle Licensing Agency (DVLA) of your altered vision or you could be fined.

    To drive legally, you need to meet the visual standards for driving set out by the DVLA. These include being able to read a number plate from a distance of 20m and having an adequate field of vision. Your field of vision is the size of area you can see when looking straight ahead. If you have only one eye, you need to have a full and unimpaired visual field in the remaining eye.

    Your optician or ophthalmologist will be able to test whether you meet the DVLA's visual standards for driving. If you don’t, you shouldn’t drive. If you have an accident, you could be prosecuted and your vehicle insurance may not cover you.

    It can take a few months for you to adjust to having only one eye so that you can drive safely. Only drive once your doctor or optician agrees that you have adapted to your altered eyesight sufficiently.

    How will radiotherapy for eye cancer affect me?

    Answer

    Having radiotherapy for eye cancer can cause some side-effects. Most of these are short term and will go away soon after you stop your treatment. However, some side-effects may last longer or appear years after treatment.

    Explanation

    Radiotherapy uses radiation to destroy cancer cells. A beam of radiation may be used to target the cancer cells in your eye. Alternatively, a source of radioactivity will be put in your eye (brachytherapy).

    Unfortunately, this radiation can also damage nearby healthy cells, causing side-effects. Temporary side-effects are listed below.

    • Losing your eyelashes. These will grow back after you stop having radiotherapy.
    • Swelling of your eye or around your eye. You will be offered eye drops or steroids to help control this.
    • Tiredness. This may carry on for a while after you stop having radiotherapy.

    Radiotherapy can sometimes cause long-term problems, such as those listed below.

    • Reduced tear production. The radiation may damage your tear gland and you may need to use eye drops to prevent sore and dry eyes.
    • Cataracts. The radiation can cause your eye lens to become cloudy and make it hard to see. This may happen years after having your treatment. You may need surgery to remove the cataracts.
    • Scarring. Radiation can cause changes to your skin.

    Ask your doctor for more information about the side-effects of radiotherapy.

    Can my eye cancer be treated with laser surgery?

    Answer

    Possibly. Whether or not laser therapy is an option for you will depend on the type of cancer you have and how far it has spread.

    Explanation

    Laser therapy uses a high-energy beam of light to destroy cancer cells. Transpupillary thermotherapy is a form of laser treatment that uses infrared light. It can sometimes be used to treat small melanomas in the lining of the eye, called uveal melanomas. Before it’s carried out, an eye drop is used to dilate your pupil so the laser can be safely directed to the tumour. This form of treatment might not work well on its own, so it is sometimes combined with radiotherapy.

    Speak to your doctor if you’d like more information about laser surgery.

  • Resources Resources

    Further information

    Sources

    • Eye cancer. Cancer Research UK. www.cancerresearchuk.org, published 24 September 2013
    • Eagle RC Jr. The pathology of ocular cancer. Eye 2013; 27:128–36. doi: 10.1038/eye.2012.237
    • Pereira PR, Odashiro AN, Lim L-A, et al. Current and emerging treatment options for uveal melanoma. Clin Ophthalmol 2013; 7:1669–82. doi: 10.2147/OPTH.S28863
    • Connors JM. Clinical manifestations and natural history of Hodgkin's lymphoma. Cancer J 2009; 15(2):124–28. doi: 10.1097/PPO.0b013e3181a282d8
    • Campbell NA. Biology. 4th ed. Menlo Park, California: The Benjamin/Cummings Publishing Company, Inc.; 1996
    • Chintagumpala M, Chevez-Barrios P, Paysse EA, et al. Retinoblastoma: review of current management. Oncologist 2007; 12(10):1237–46
    • Eye cancer (retinoblastoma). Cancer Research UK. www.cancerresearchuk.org, updated 5 September 2013
    • Canning CR, MacCartney ACE, Hungerford J. Medulloepithelioma (diktyoma). Br J Opthalmol 1988; 72:764–67
    • Overview of intracranial tumors. The Merck Manuals. www.merckmanuals.com, updated August 2013
    • Standards of vision for driving cars and motorcycles (group 1): guidance INF188/1. Driver and Vehicle Licensing Agency, www.gov.uk, updated 4 September 2014
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