Eye Cancer: Risk Factors, Types, Symptoms and Treatment

Eye cancer is the term generally used to describe various types of tumours appearing in different parts of the eye. A tumour appears when cells in or around the eye grow in a disorderly manner.

Tumours are of two types - benign and cancerous. Benign tumours can grow but do not spread. On the contrary, cancerous tumours can grow and spread to other parts of the body. A cancerous tumour occurring within the eyeball is known as intraocular (inside the eye) malignancy.

What Are the Risk Factors Associated With Eye Cancer?

To fully understand what causes eye cancer, you first need to know the risk factors. Anything that amplifies a person’s chance to develop cancer is known as a risk factor. Risk factors may influence cancer development. But they never cause cancer directly.

As a result, people with multiple risk factors may never develop eye cancer. On the other hand, people with no known risk factor can develop cancer in the eyes.

Some risk factors or eye cancer reasons are listed below.

Age: The people most likely to be diagnosed with intraocular cancer are over the age of 50. With an average age of diagnosis at 55, intraocular cancer is less common in people above 70 and children.
Race: As per studies, eye cancer is more common in light-skinned people than dark-complexioned people.
Gender: Intraocular cancer affects women and men almost equally.
Personal Medical History: People having nevi or moles in their eyes are more prone to cancer in the eyes.
Family Medical History: Certain types of intraocular cancer can be genetic and run in the family.
Others: As per some studies, certain chemicals, radiation exposure and sunlight can put an individual at risk of intraocular cancer.

Although the exact reasons for most eye cancers are unknown, scientists have learnt that certain DNA changes can convert cells to cancer. DNA changes that activate oncogenes or deactivate tumour suppressor genes can cause cancer.

Now that you know the reasons for eye cancer let’s dive in deeper to understand the different types of eye cancer.

What Are the Different Types of Eye Cancer?

Intraocular cancer can be classified into mainly seven categories.

Melanoma: Melanoma mainly occurs in adults. It starts when melanocyte cells grow uncontrollably. Uveal melanoma is another name for intraocular melanoma.
Intraocular Lymphoma: Intraocular Lymphoma is a rare condition that doctors find difficult to diagnose.
Retinoblastoma: Retinoblastoma is a rare form of eye cancer common in children.
Hemangioma: Hemangioma starts in the blood vessels and appears in the retina and choroid.
Conjunctival Melanoma: This tumour appears in the conjunctiva, a membrane lining the eyeball and eyelids. Conjunctival melanoma can spread to the lymph nodes if left untreated. In addition, it tends to reappear after the treatment.
Eyelid Carcinoma: It is a variation of skin cancer and can be surgically removed. It is usually not life-threatening if removed early.
Lacrimal Gland Tumor: It appears in the lacrimal glands of the eyes that produce tears.

Now, let’s proceed with the eye cancer symptoms.

What Are the Symptoms of Eye Cancer?

Eye cancer does not usually show early symptoms. In addition, the advanced stage symptoms may also go unnoticed. However, some prominent signs and symptoms of eye cancer are listed below.

Eye flashes or eye floaters
Shadows around images, haloes, blurred vision
Eye bulging
Dark moles in the sclera of the eye, increasing in size or bleeding
Reduced vision with pain
Iris colour changes
Tumour or lump in the eyelid, growing and acquiring blood vessels

Children, on the other hand, have a separate set of eye cancer symptoms.

Excessive tearing
The centre of the eye becomes white in colour
Eye swelling and redness

These are the most notable signs of eye cancer for adults and children. Now that you know how to detect eye cancer, let's learn about its different stages.

Different Stages of Eye Cancer

Doctors further classify intraocular cancer based on four parameters - T (Tumour), N (Node), M (Metastasis) and G (Grade). They then assign the stage of eye cancer by combining these classifications.

The different stages of intraocular cancer are listed in the table below.

Stage	Tumour Size	Description and Conditions
Stage I	Category 1	It does not affect other parts of the eye, ciliary body or regional lymph nodes (T1a, N0, M0).
Stage IIA	Category 1	It may or may not affect the ciliary body. It can be with or without extraocular extension (T1b, T1c, T1d).
Stage IIA	Category 2	It does not affect the ciliary body. It has not spread to other body parts or the regional lymph nodes (T2a, N0, M0).
Stage IIB	Category 2	It involves the ciliary body. It has not spread outside the eyeball (T2b, N0, M0).
Stage IIB	Category 3	It has not spread to the ciliary body, regional lymph nodes, eyeball or other body parts (T3a, N0, M0).
Stage IIIA	Category 2	There is an extraocular spread of diameter 5 mm or less with or without affecting the ciliary body. It has not spread to the lymph nodes or other body parts (T2c or T2d, N0, M0).
Stage IIIA	Category 3	It may or may not affect the ciliary body. There may or may not be an extraocular spread of diameter 5 mm or less. It has not spread to the lymph nodes or other body parts (T3b or T3c, N0, M0).
Stage IIIA	Category 4	It does not affect the ciliary body. It has not spread to the lymph nodes or other body parts (T4a, N0, M0).
Stage IIIB	Category 3	It has affected the ciliary body with an extraocular spread. It has not spread to the lymph nodes or other body parts (T3d, N0, M0).
Stage IIIB	Category 4	It may or may not affect the ciliary body. The tumour may or may not have spread outside the eyeball. It has not spread to the regional lymph nodes or other body parts (T4b or T4c, N0, M0).
Stage IIIC	Category 4	It affects the ciliary body and has spread beyond the eyeball. It has not spread to the regional lymph nodes or other body parts (T4d or T4e; N0, M0).
Stage IV	Any size	It has spread to the lymph nodes and/or other body parts beyond the eye (any T, N1, M0; or, any T, any N, M1).

How to Diagnose Eye Cancer?

Doctors conduct several tests to diagnose eye cancer and assess how much it has spread in the body. Some tests can help them determine which treatments are going to be most effective. Doctors consider several factors like age and medical condition, suspected type of cancer, signs and symptoms and previous test results before conducting the tests.

Doctors generally conduct these tests to diagnose eye cancer.

Eye examination
Ultrasound
Fluorescein angiography
Fine needle biopsy
Cytogenetics and gene expression profiling
Computed tomography (CT or CAT) scan
Magnetic resonance imaging (MRI)
Positron emission tomography (PET) scan

What Are the Treatments for Eye Cancer?

Before proceeding with the treatments, doctors recommend an active observation approach based on the diagnosed stage of intraocular cancer. Here, they monitor the patient closely to check if the tumour is growing or spreading aggressively.

Based on the observations, doctors widely follow these eye cancer treatment procedures.

Surgery

Doctors can surgically remove the tumour along with some adjacent healthy tissue. The widely practised surgical options include:

Iridectomy - Here, doctors remove a part of the iris.
Iridocyclectomy - In this case, surgeons remove a part of the iris and ciliary body.
Endoresection or Sclerouvectomy - Here, doctors remove the choroidal tumour but keep the eye
Enucleation - In this case, surgeons remove the entire eye.

Doctors can also perform surgery to insert a radioactive disc for internal radiation therapy purposes, also known as brachytherapy.

Surgery for eye cancer causes various side effects like general anaesthesia problems, risk of infection and pain.

Radiation Therapy

In radiation therapy, doctors use high-energy x-rays or other particles to destroy cancer cells. It usually consists of a schedule, i.e., a specific number of treatments provided over a specific time period.

When doctors provide radiation treatment using implants, it is known as internal radiation therapy, plaque therapy, or brachytherapy. Radiation therapy may bring along several side effects. As a result, doctors first recommend other treatments.

Laser Therapy

In laser therapy, doctors shrink a smaller tumour by applying heat in the form of a laser. It is also known as transpupillary thermotherapy (TTT). Laser therapy comes with potentially lesser side effects than radiation therapy or surgery. Doctors can also perform laser therapy and radiation therapy in tandem.

However, despite enduring the eye cancer treatment cost, recovery is not always possible.

Survival rates provide an idea of the percentage of people with similar types and stages of intraocular cancer surviving a certain period of time since their diagnosis.

They cannot determine how long an individual will live. However, they can provide them with a clearer understanding of their situation.

For example, SEER (Surveillance, Epidemiology, and End Results) tracked survival rates of US citizens diagnosed with intraocular cancer from 2009 to 2015. Here are the statistics in terms of localised, regional and distant SEER stages.

Stage	Relative Survival Rate (5 Years)
Localised	85%
Distant	13%
Regional	71%
All stages combined	82%

How to Prevent Eye Cancer?

Doctors and scientists have not yet figured out what causes most intraocular cancers. As a result, eye cancer prevention is not possible yet.

However, scientists have discovered a link between sunlight and skin melanomas. So, you can take certain precautions to reduce the risk of developing intraocular cancer. These precautions include limiting sunlight exposure and wearing UV-protected sunglasses.

As per studies, wearing UV-protected sunglasses with over 99% UVA and UVB absorption can protect your eyes. This, in turn, might help bring down the chances of developing intraocular cancer.

Going through all the intricate details presented here, you now have a clearer understanding of eye cancer and the related treatment procedures. You will also be able to minimise the risk of developing this disease with the shared precautions.

Frequently Asked Questions

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Where do eye cancers begin?

Eye cancer can begin to develop in all 3 major parts of the eye - eyeball, orbit and globe.

What is the most common type of eye cancer?

Intraocular melanoma is the most common type of eye cancer and occurs mainly in adults.