Eye (Intraocular) Cancer

Overview

Eye cancer – or intraocular cancer – refers to any type of cancer that occurs in the eye. There are two main classes of eye cancer, based on where they start.

Primary intraocular cancers

Primary intraocular cancer begins in the eye.

The most common types of primary intraocular cancers in adults are:

• Melanoma
• Non-Hodgkin’s lymphoma

The most common types of primary intraocular cancers in children are:

• Retinoblastoma – this type begins in the retina, which is the very back part of the eye.
• Medulloepithelioma – this very rare type begins in the ciliary body, which is near the front of the eye.

Secondary intraocular cancers

Secondary intraocular cancer begins elsewhere in the body, most often the breast or lung, and then spreads to the eye.

Eye cancer causes

Eye cancer is caused when mutations (changes) occur in the cells of the eye, and then those cells grow and multiply quickly.

Eye cancer risk factors

The following factors may increase your risk for developing eye cancer:

• Being Caucasian
• Being male
• Being older
• Having a family history of eye cancer
• Having BAP1 cancer syndrome, a rare inherited condition
• Having certain types of moles (nevi) on the skin, especially large or dark moles
• Having dysplastic nevus syndrome, a condition that affects the skin
• Having lighter colored eyes, such as blue or green

Eye cancer symptoms

Many people with eye cancer won’t experience any symptoms until the cancer becomes more advanced. When they occur, signs and symptoms of eye cancer can include:

• Bulging of the eye
• Change in how your eye moves within the socket
• Change in position of your eyeball within the socket
• Change in the size of your pupil (inner dark spot of the eye)
• Flashes of light in your vision
• Floaters (spots) in your vision
• Growing dark spot on your iris (colored part of your eye)
• Losing part of your field of vision, such as side (peripheral) vision
• Trouble with or changes in vision

Eye cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam – your doctor will perform a complete physical exam – including asking questions about your health history, your symptoms and related risk factors. Your doctor will closely examine your eye with specialized equipment.
• Biopsy – in this test, your doctor removes a biopsy (small sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for cancer. 
• Chest X-ray – if you have eye melanoma, your doctor may perform an X-ray of your chest to check if the cancer has spread to your lungs.
• Computerized tomography (CT) scan – this type of imaging test provides a 3D image of the inside of the body that your doctor can use to determine the size and location of the cancer.
• Liver function test – if you have eye melanoma, your doctor may order this test to check to see how well your liver is working.
• Magnetic resonance imaging (MRI) – this type of imaging test uses high-powered magnets to create detailed images of the inside of your body. Your doctor can closely examine these images to determine the size and location of the cancer.
• Optical coherence tomography (OCT) – this specialized type of ultrasound uses light waves to create highly detailed images of the back of the eye.

Eye cancer treatments

Depending on your personal health history, the extent of the eye cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery – you may need to undergo surgery to remove the cancerous area. Your surgeon will work to preserve as much surrounding healthy tissue as possible.
• Chemotherapy – you may need to also undergo chemotherapy to destroy any cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Laser therapy – if surgery or radiation therapy are not options for you, your doctor may recommend you undergo laser therapy to treat eye cancer. During this treatment, high-powered lasers use light beams to destroy the cancer.
• Radiation therapy – this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldn’t be removed surgically.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.