Types of eye cancer
There are various types of eye cancer, including melanoma, lymphoma, and retinoblastoma, all of which are rare. Cancer that first starts in the eye is known as primary eye cancer. Cancer that has spread to the eye from another part of the body is known as secondary cancer. Eye cancers that develop inside the eye are intraocular cancers, and they can affect the eyeball and internal parts of the eye, like the retina. Cancers that affect areas around the eye, like the socket and eyelid, are extraocular cancers.
Eye cancer can develop without causing symptoms, and other more common eye conditions can cause similar symptoms. Regular eye tests check your eyesight and the health of your eyes and can detect changes before you might notice them. If your optician suspects eye cancer, they can refer you to an ophthalmologist (a specialist eye doctor).
The earlier eye cancer is diagnosed, the better the prospects for treatment usually are. Treatment options vary depending on the type of eye cancer, but chemotherapy and radiotherapy are common. Your healthcare team will discuss your treatment plan and any possible side effects with you.
Melanomas are tumours that grow from cells called melanocytes. These cells produce pigment, and when they divide and grow abnormally, they cause melanoma. Most people have heard of skin melanoma, but melanoma can also happen in the eyes, known as ocular melanoma.
Eye melanomas can affect different parts of the eye. The most common type of eye melanoma involves the uvea, the middle part of the eye.
The uvea is the middle part of the eye, containing the iris, ciliary body and choroid. Uveal melanomas can affect each of these different parts of the uvea.
Conjunctival melanoma affects the conjunctiva, the thin layer covering the front of the eye and inside the eyelid. It can show as dark spots on the eye that look pink or brown. These can be confused with other conditions, making diagnosis difficult and sometimes pigment spots occur naturally on the white of the eye. Conjunctival melanoma typically affects people in their fifties and older (Source: Medscape).
Lymph cells form part of our immune system and are present throughout the body. Lymphoma develops in these lymph cells and can occur in the eye, known as ocular lymphoma. Ocular lymphoma can be hard to diagnose, as the symptoms are similar to chronic uveitis.
Primary intraocular lymphoma
Intraocular lymphoma is a non-Hodgkin lymphoma that happens when cancer develops in uveal tissue in the eye. It usually affects both eyes and can spread to the central nervous system, including the brain. People are generally diagnosed in their fifties or sixties (Source: Clinical Ophthalmology). Diagnosis can be slow because people are often first treated for uveitis before their lymphoma is detected.
Ocular adnexal lymphoma
Ocular adnexal lymphoma occurs around the eye and can affect the eye socket, eyelid, lacrimal gland (which produces tears) and conjunctiva, the membrane that lines the outside of the eye. It can cause eye pain and a lump but may have no obvious symptoms at first. After treatment, including radiation therapy and chemotherapy, regular follow-up appointments check the cancer has not spread or returned.
Retinoblastoma affects the nerves in the retina, the light-sensitive layer of cells at the back of the eye. Retinoblastoma is very rare and typically develops in very young children under five. Between 40 to 50 children are diagnosed with retinoblastoma each year in the UK (Source: Patient). Early diagnosis and specialist care from the NHS means that survival rates for children with retinoblastoma in the UK are very high.
Squamous cell carcinoma of the eye
Squamous cell cancer more often develops in the skin, but there are several squamous cell cancers that can affect the eye.
Squamous cell carcinoma of the conjunctiva
Squamous cell carcinoma is the most common type of cancer in the conjunctiva, the membrane that lines the eye. It’s generally slow-growing and only rarely spreads elsewhere in the body. Symptoms and signs can include redness, irritation, and sensitivity to light, usually in one rather than both eyes.
Squamous cell carcinoma of the eyelid
Squamous cell carcinoma is a type of skin cancer that can develop on the eyelid. Exposure to ultraviolet light is a risk factor. Cancer can spread to deeper layers of the skin but does not tend to spread beyond the eye.
Basal cell carcinoma of the eyelid
Basal cell cancers (sometimes known as rodent ulcers) develop in the skin and can grow on the skin of the eyelids or skin near the eye. Exposure to ultraviolet light is a risk factor. Basal cell cancer doesn’t often spread further but will get bigger unless treated.
Lacrimal gland cancer
Lacrimal glands produce fluid (including tears) that helps protect our eyes. They are in the upper eyelids. Lacrimal gland cancers include lymphoma and carcinomas; all are rare. Lacrimal gland cancer can sometimes develop from a benign tumour that becomes cancerous.
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The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.