Eye neoplasm

Eye Neoplasm Microchapters
Patient Information
Overview
Classification Choroidal Tumors Conjunctival Tumors
Causes
Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roukoz A. Karam, M.D.[2]

Synonyms and keywords: Eye neoplasm; eye cancer

Overview

Ocular oncology is the branch of medicine dealing with tumors relating to the eye and its adnexa. Cancer of the eye is very rare; however, the most common neoplasm of the eye is ocular melanoma. Eye cancer can affect all parts of the eye.

Classification

• The most common intraocular cancer in adults is uveal metastases
• Melanoma is the most common type of primary intraocular cancer in adults
  • uveal melanoma
• Intraocular lymphoma is lymphoma that begins in the eyeball
  • consider intraocular lymphoma to be a type of central nervous system lymphoma. Most intraocular lymphomas are non-Hodgkin lymphoma.
• Retinoblastoma is a rare form of childhood eye cancer.
• Hemangioma is a benign tumor of the choroid and retina that starts in the blood vessels.
• Conjunctival melanoma is a tumor of the conjunctiva
• Eyelid carcinoma (basal or squamous cell) is a variation of skin cancer.
• Lacrimal gland tumor is a benign or malignant tumor of the glands that produce tears
• Tumors in the eye and orbit can be
  • Benign like dermoid cysts, or
  • Malignant like rhabdomyosarcoma and retinoblastoma
• Most common eyelid tumor is basal cell carcinoma
  • Can grow around the eye but rarely spreads to other parts of the body
  • Other common eyelid cancers are squamous carcinoma, sebaceous carcinoma and malignant melanoma

• Most common malignant primary intraocular tumor in adults is uveal melanoma
  • Can occur in the choroid, iris and ciliary body

• Most common malignant intraocular tumor in children is retinoblastoma
  • Affecting approximately 325 children per year in North America
  • Early detection has allowed for cures exceeding 95%

• Most common orbital malignancy is orbital lymphoma
  • Can be diagnosed by biopsy with histopathologic and immunohistochemical analysis
  • Most patients offered chemotherapy or radiation therapy

• Orbital dermoid cysts
  • Benign choristomas
  • Usually found at the junction of sutures (most commonly fronto-zygomatic suture)
  • Can cause pressure effects on the muscles and optic nerve, leading to diplopia and loss of vision

Choroidal tumors

• Choroidal hemangioma

• Choroidal melanoma

• Choroidal metastasis

• Choroidal nevus

• Choroidal osteoma

• Ciliary body melanoma

• The nevus of Ota

Conjunctival tumors

• Conjunctival Kaposi's sarcoma

• Epibulbar dermoid

• Malignant conjunctival tumors

• Lymphoma of the conjunctiva

• Melanoma and PAM with atypia

• Pigmented conjunctival tumors

• Pingueculum

• Pterygium

• Squamous carcinoma and intraepithelial neoplasia of the conjunctiva

Risk Factors

Risk factors that increase the chance of suffering from cancer of the eye include:

• Light skin and/or blue eyes
• Exposure to sun or tanning beds
  • Increase risk of eyelid carcinomas or melanomas
• Exposure to certain viruses
  • Human papilloma virus may increase the risk of squamous cell carcinoma of conjunctiva
• Atypical mole and melanoma syndrome (originally called dysplastic nevus syndrome)

Diagnosis

• Melanomas (choroidal, ciliary body and uveal) - In the early stages there may be no symptoms (the person does not know there is a tumor until an ophthalmologist or optometrist looks into the eye with an ophthalmoscope during a routine test). As the tumor grows, symptoms can be blurred vision, decreased vision, double vision, eventual vision loss and if they continue to grow the tumor can break past the retina causing retinal detachment. Sometimes the tumor can be visible through the pupil.

• Nevus - Are benign, freckle in the eye. These should be checked out and regular checks on the eye done to ensure it hasn't turned into a melanoma.

• Iris and conjuctival tumors (melanomas) - Presents as a dark spot. Any spot which continues to grow on the iris and the conjunctiva should be checked out.

• Retinoblastoma - Strabismus (crossed eyes), a whitish or yellowish glow through the pupil, decreasing/loss of vision, sometimes the eye may be red and painful. Retinoblastoma can occur in one or both eyes. This tumor occurs in babies and young children. It is called RB for short. Check photographs, normal healthy eyes would have the red eye reflex, but a white/yellow dot instead of the red eye reflex can indicate a tumor or some other kind of eye disease. Any photos of a child/children which have a white/yellow dot instead of the red eye reflex should be checked out.
  

Related Chapters

• List of eye diseases and disorders