Eye Cancers in Brief

Eye cancer is the growth of malignant cells in the tissues of the eye. In adults, most eye cancers are secondary tumors that have spread to the eye from other parts of the body (often the breast, although cancers of the lungs, kidneys and prostate gland are sometimes involved) via the bloodstream or the lymphatic system.

Two primary tumors arise within the eyes: retinoblastomas and melanomas. Among children, retinoblastoma is the most common primary eye cancer; it affects children under age five. Malignant melanoma of the eye is found most frequently in adults; average age at diagnosis is 60 to 65 years old. Most eye cancers affect only one eye, but retinoblastoma involves both eyes in about one-third of cases.

Symptoms may not be evident in the early stages of any form of eye cancer; however, growing tumors may increasingly cause pain and impair vision. Cancer of the eye may spread (metastasize) to the optic nerve, the brain or the rest of the body, so early diagnosis and treatment are important.

Treatment for eye cancer is aimed at destroying cancerous cells, relieving symptoms and preserving as much sight as possible. Treatment for secondary eye tumors also involves treating the primary cancer elsewhere in the body.

Causes

It is not known why primary eye melanomas arise. The most common cause of metastatic eye cancer in adults is the spread of a tumor from another site in the body. Genetic factors play a role in retinoblastoma.

Symptoms

• Gradual distortion and loss of vision in the affected eye
• Pain and redness in the affected eye
• Different color irises in each eye
• Bleeding in the eye
• Bulging eyes (when a secondary tumor is located behind the eyeball)

In retinoblastoma, an eye may turn in or out (crossed eyes). Later, visible whiteness in the pupil may be seen.

Melanomas often produce no symptoms. Sometimes blurred vision or seeing flashing lights occurs. A black or brown spot on the iris or the white of the eye can develop.

Prevention

If retinoblastoma runs in your family, genetic counseling is advised before having children. Newborns and children in families with a history of retinoblastoma should have regular eye examinations.

Diagnosis and treatment

An ophthalmologist will conduct a complete eye examination, possibly using general anesthesia on children. An ultrasound examination and sometimes computed tomography (CT) scans of the head and eye may be performed. Ultrasound is the more useful and common diagnostic tool.

Laser surgery or cryosurgery (freezing the targeted tissue with liquid nitrogen) may be used to destroy small tumors. Radiation therapy may be used to kill cancerous cells together with or instead of surgery. Chemotherapy may be used to halt or limit the spread of the cancer. Recently, new chemotherapeutic agents have been successful in treating retinoblastoma within the eye.

Surgical removal of the eye may be necessary to prevent the cancer from spreading, or when an eye is completely blinded and painful.

When to call your doctor

Make an appointment with an ophthalmologist if you develop any of the symptoms of eye cancer.

Last Updated: 1/15/2003
The Johns Hopkins University 1996-2003.  All rights reserved.  This information is not intended to provide advice on personal medical matters, nor is it intended to be a substitute for consultation.