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What Are the Symptoms of Eye Cancer?

A woman's eye shown close up
Symptoms of eye cancer occur may include vision problems (blurred vision, partial or total sudden loss of vision, partial loss of the field of sight), floaters, shadows or flashes of light, a growing dark spot on the colored part of the eye (iris), change in size or shape of the pupil, and others.

Eye cancer occurs when cells in the eye grow out of control. 

Types of eye cancer include: 

  • Intraocular melanoma
    • The most common type of intraocular eye cancer in adults, though it is rare 
    • Usually develops in the uvea (uveal melanomas) and less commonly in the conjunctiva (conjunctival melanomas)    
  • Squamous cell carcinoma
    • The most common type of conjunctival eye cancer
    • Affects the surface of the eye
  • Ocular lymphoma
    • The most common type of malignant eye tumor
    • Can develop in the retina, in the vitreous inside the eye, and can also affect the optic nerve at the back of the eye
  • Retinoblastoma 
    • A childhood cancer
    • Affects the retina

10 Eye Cancer Symptoms

Eye cancers may not cause symptoms early on unless cancer grows in certain parts of the eye or becomes more advanced. When symptoms of eye cancer occur, they may include:

  • Vision problems
    • Blurred vision
    • Partial or total sudden loss of vision
    • Partial loss of the field of sight
  • Floaters 
  • Shadows or flashes of light
  • A growing dark spot on the colored part of the eye (iris)
  • Change in size or shape of the pupil 
  • Change in position of the eyeball within the socket
  • Change in the way the eye moves within the socket
  • Bulging eye
  • Lump on the eye or in the eyelid that is growing
  • Pain in or around the eye (rare)

What Causes Eye Cancer?

The exact cause of most eye cancers is unknown. 

Risk factors for developing eye cancers include: 

  • Race/ethnicity
    • The risk is higher in people who have fair skin than it is in African Americans, Hispanics, or Asian Americans
  • Eye color
    • People with light-colored eyes such as blue, green, or gray, are slightly more likely to develop eye cancer than people with darker eye and skin color
  • Age 
    • Risk increases as people age
    • Most cases of eye cancer are diagnosed in people in their 50s
  • Gender
    • Slightly more common in men than in women
  • Unusual moles
    • People who have irregularly-shaped or unusually-colored moles on the skin are at increased risk of developing eye melanoma along with skin cancer
  • Ultraviolet (UV) radiation exposure
    • Exposure to UV rays from sunlight or tanning beds can increase the risk
  • Certain inherited conditions
    • Dysplastic nevus syndrome 
    • Many abnormal moles on the skin
    • Abnormal brown spots on the uvea (oculodermal melanocytosis or nevus of ota) 
    • Bap1 cancer syndrome 
    • Moles (nevi) in the eye or on the skin 
  • Family history (rare)

How Is Eye Cancer Diagnosed?

Eye cancer is diagnosed with an eye exam, patient history, and tests such as:

  • Imaging tests
  • Biopsy
    • Fine needle aspiration
    • Fine needle biopsy of the tumor
    • Incisional or excisional biopsy (cutting out part or all of the tumor)
    • Liquid biopsy
  • Blood tests

What Is the Treatment for Eye Cancer?

Treatment for eye cancer may include one or more of the following: 

  • Radiation therapy 
    • Brachytherapy (plaque therapy)
    • External beam radiation therapy
      • Proton beam radiation therapy
      • Stereotactic radiosurgery
  • Surgery 
    • Iridectomy: Removal of part of the iris 
    • Iridotrabeculectomy: Removal of part of the iris, plus a small piece of the outer part of the eyeball
    • Iridocyclectomy: Removal of a portion of the iris and the ciliary body
    • Transscleral resection: Surgical removal of just a melanoma of the ciliary body or choroid
    • Enucleation: Removal of the entire eyeball
    • Orbital exenteration: Removal of the eyeball and some surrounding structures such as parts of the eyelid and muscles, nerves, and other tissues inside the eye socket. May be used for melanomas that have grown outside the eyeball into nearby structures. 
  • Laser therapy 
    • Transpupillary thermotherapy (TTT) is the most common type of laser treatment for eye melanoma that uses infrared light to heat and kill the tumor
    • Laser photocoagulation uses highly focused, high-energy light beams to burn tissue (rarely used because of side effects and a high risk of recurrence)
  • Targeted drugs and immunotherapy 
    • Pembrolizumab (Keytruda)
    • Ipilimumab (Yervoy) 
  • Chemotherapy 
    • Used more often for eye lymphoma or retinoblastoma
    • Melanoma usually does not respond well to standard chemo drugs

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References
REFERENCES:

Image source: iStock Images

https://www.cancer.org/cancer/eye-cancer.html

https://www.nhs.uk/conditions/eye-cancer/

https://www.aao.org/eye-health/diseases/eye-lymphoma