This factsheet is for people who have eye cancer, or who would like information about it.
Eye cancer is a lump in or around your eye that is created by an abnormal and uncontrolled growth of cells.
- How cancer develops
- About eye cancer
- Symptoms of eye cancer
- Causes of eye cancer
- Diagnosis of eye cancer
- Treatment of eye cancer
- Help and support
How cancer develops
About eye cancer
Eye cancer is caused by an uncontrolled growth of cells in or around the eye. Cancer of the eye is very rare in the UK; about 430 people get it each year.
Types of eye cancer
There are several different types of eye cancer.
Cancer that develops in your eye is called intraocular cancer. Cancer that develops outside your eye is called extraocular cancer.
Intraocular eye cancers
Types of intraocular eye cancer include the following.
- Ocular melanoma. This usually develops in the lining of your eyeball, the muscles that focus your eye, the iris (the coloured part of your eye) or the inner surface of your eyelids (conjunctiva). Melanoma is one of the most common types of intraocular eye cancers.
- Non-Hodgkin’s lymphoma. This usually develops in your lymph nodes. Lymph nodes are glands throughout your body that are part of your immune system. However, non-Hodgkin’s lymphoma sometimes develops in your eye.
- Retinoblastoma. This usually develops in the nerve cells of the retina and can affect one or both of your eyes. It’s often inherited and develops in young children, usually under five. Over nine out of 10 children with retinoblastoma are cured with the right treatment.
Extraocular eye cancers
Extraocular eye cancers include the following.
- Basal cell carcinoma. This is the most common type of skin cancer. It often develops near your eye, especially on your lower eyelid. It causes a small red growth on your skin that often has a rolled edge to it. It doesn’t usually spread to other parts of your body, but it can affect surrounding tissue if it isn’t treated.
- Squamous cell carcinoma. This usually develops on the surface of your eyelid.
- Rhabdomyosarcoma. This is a very rare type of eye cancer that develops in the muscles that move your eye. It mostly affects children.
- Optic nerve tumour. This is a rare tumour that can develop in your optic nerve, which connects your eye to your brain.
Secondary eye cancers
Sometimes a cancer can spread to your eye from another part of your body. This is called a secondary eye cancer. This is most likely to happen in women with breast cancer, and in men with lung cancer.
Symptoms of eye cancer
Symptoms of eye cancer vary depending on the type of cancer you have and where it’s located.
If you have an intraocular cancer, such as ocular melanoma, you might not have any symptoms and it will be detected in a routine eye examination. This is why it’s important to have an eye test every two years.
If you do have symptoms of eye cancer, they may include:
- partial or complete loss of vision
- seeing flashing lights or spots
- a dark spot on your iris that’s growing
- a visible lump on your eyelid with crusting or bleeding
- a bulging eye
- watery eyes
- pain in or around your eye, although this is quite rare
These symptoms aren’t always caused by eye cancer and could be caused by a number of other reasons, but if you have any of them, see your GP or optician.
Most children with retinoblastoma look well, but parents may notice a squint or an odd looking pupil that looks white. Their eye may also look red and inflamed.
Causes of eye cancer
The exact reasons why you may develop eye cancer aren’t fully understood at present. However, you may be more likely to develop certain types of eye cancer if you have:
- blue, grey or green eyes
- unusual brown spots on your eye
- lots of unusually shaped or large moles (atypical mole syndrome)
- been out in the sun too much without wearing sun protection, such as sunglasses or a wide-brimmed hat
- a weakened immune system – people who have HIV/AIDS or who are taking medicines that suppress their immune system are more likely to develop lymphoma of the eye
- inherited genes – four out of 10 children with retinoblastoma inherit a faulty gene from their parents
Diagnosis of eye cancer
Your GP or optician will ask about your symptoms and examine you. He or she may also ask you about your medical history.
If your GP or optician thinks that you have eye cancer he or she will refer you to an ophthalmologist (a doctor who specialises in eye health, including eye surgery). If your ophthalmologist suspects you have eye cancer, he or she may refer you to a specialist centre for eye cancer.
You may have the following tests to confirm the diagnosis.
- Eye examination – your doctor or optician will shine a light into your eye and look inside with special hand-held instruments. Your doctor may put drops into your eyes – this can affect your vision for a short while.
- Fluorescein angiography – your doctor will inject a dye into your arm which will travel through your bloodstream to the blood vessels in your eyes where it will show up on photographs so he or she can look at the blood vessels in your eyes.
- Ultrasound scan – you doctor will move a small ultrasound sensor over your closed eyelids or on the skin around your eye. An ultrasound uses sound waves to produce an image of the inside of your eye.
- CT or MRI scan – you may have one of these tests to check the muscle and tissues in and around your eye. A CT scan uses X-rays to make a three-dimensional image of your body. An MRI scan uses magnets and radiowaves to produce images of the inside of your body.
- Biopsy – using a fine needle, your doctor will take a sample of the fluid inside your eye or on the surface around your eye. This will be sent to a laboratory for testing to determine the type of cells and if these are benign (not cancerous) or cancerous.
Treatment of eye cancer
Your treatment will depend on the type of eye cancer you have, the size and how far it has spread (which is called staging) and your general state of health. There are three main treatments for eye cancer.
Surgery usually involves removing just the affected tissue. This is often enough to remove most eyelid tumours. However, you may need to have a small part of your eye, or if the cancer affects a large part of your eye, your whole eye removed (enucleation surgery). If you have your eye removed an artificial (prosthetic) eyeball can be created to match your remaining eye. This will last for your lifetime, you won’t need to have it replaced.
If the cancer has spread you may need to have your eye and eyelid, and the muscles, nerves, and fat in your eye socket removed (exenteration surgery). After this surgery you may have an artificial eye or a facial prosthesis fitted.
Some types of eye cancer, such as melanoma of the eye, can be treated with laser therapy (a high-energy beam of light will be used to destroy the cancer cells).
Surgery is sometimes combined with radiotherapy to treat eye cancer. Radiotherapy uses radiation to destroy cancer cells. A beam of radiation is targeted on the cancerous cells, which shrinks the tumour. Radiotherapy can now be targeted to the area that needs treating to prevent damaging normal tissues close by. Alternatively a source of radioactive material will be put in or near your tumour. This is called brachytherapy.
Radiotherapy is often used to treat melanoma of the eye.
The length of your radiotherapy treatment will depend on what type of eye cancer you have and how severe it is. If you have ocular melanoma for example, you will usually have external beam radiotherapy as small doses over a few days, or brachytherapy for a week. Ask your doctor for information on the type and length of treatment you need.
Chemotherapy is a treatment to destroy cancer cells with medicines. They are usually injected into your vein but sometimes may be given as tablets.
Chemotherapy can be effective for treating lymphoma of the eye and retinoblastoma. It’s only used for melanoma of the eye if other types of treatment haven’t worked.