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Eye cancer affects three areas of the eye — the eyeball itself (called the globe), the area around the eye (the orbit), and the accessory structures (such as the eyelids and tear ducts, called adnexal structures). Eye cancers are also divided into two groups — primary eye cancers that start in the eye (intraocular) and secondary eye cancers that start elsewhere in the body and spread to the eye. Today we will examine melanoma and lymphoma, the two most common primary eye cancers.

INTRAOCULAR MELANOMA

Intraocular melanoma is the most common type of eye cancer, and usually occurs in the uvea, the middle layer of the front of the eye containing the iris and structures that allow the eye to adjust to light and distances. This cancer grows slowly and rarely spreads to other parts of the body.

INTRAOCULAR LYMPHOMA

Lymphoma is a type of cancer that begins in the immune system cells, and is either Hodgkin or non-Hogdkin in variety. In eye cancer, lymphoma is always of the non-Hodgkin type. It is most common in the elderly or those with immune compromising illnesses, particularly AIDS. It also is often seen in conjunction with lymphoma of the brain, or central nervous system lymphoma. This eye cancer is rare.

RISK FACTORS FOR DEVELOPING PRIMARY EYE CANCER

The risk factors for eye cancer include smoking and family history of cancers, being white or having lighter colored eyes, being male, or being elderly. An additional risk factor is unusual brown spots in the uvea, just as abnormal moles on the skin are cause for greater concern about skin cancers. Those with AIDS or who are taking anti-rejection drugs after organ or tissue transplants are also at greater risk.

PREVENTION

There are no specific preventions for eye cancer, but follow these steps to protect your help protect your eyes:

  • Limit sun exposure, particularly when it is intense
  • Wear protective clothing and a hat with a wide brim
  • Use sunglasses with wrap-around features and 99-100% UVA and UVB absorption labels
  • Use sunscreen on all exposed skin, including on the face
  • Take steps to avoid contracting HIV, the virus that causes AIDS
  • Eat a healthy diet and exercise regularly to keep your immune system in good working order

SIGNS AND SYMPTOMS OF EYE CANCER

If you have any of these symptoms, seek immediate evaluation as they could be related to cancer as or a number of other eye illnesses:

  • Vision changes include blurring or sudden loss of vision (these are emergencies)
  • Loss of part of the visual field (treat this as an emergency)
  • Floaters (drifting spots in the field of vision) or flashes of light (these may indicate problems, but also can be related to aging)
  • Visible, growing dark patch on the iris
  • Size or shape changes of the pupil not related to changes in light
  • Changes in position or movement of the eyeball in the eye socket, or bulging of the eye
  • Redness or swelling without obvious cause

DIAGNOSIS AND TREATMENT OF EYE CANCER

Most patients are diagnosed during a routine eye examination. It is extremely important to have regular, annual eye exams. If you notice changes to or around your eyes between exams, make an appointment to be evaluated right away, even if you’ve just seen your doctor. Once diagnosed, your treatment plan may include one or several of these options, and will be based on your type of cancer, your age and other health factors, and how advanced your cancer is:

  • Radiation or chemotherapy
  • Laser therapy
  • Targeted drug therapy
  • Medication, particularly immunotherapy drugs, targeted drugs, or antibodies

After diagnosis, you may undergo additional tests such as an ultrasound, chest x-ray, or MRI, a biopsy, or blood work. These tests are beneficial in determining if your cancer has spread or if it started elsewhere in the body, what type of cancer you have, and how advanced it is.

If you or someone you love has concerns about possible eye cancer, be sure to contact your Silverstein Eye Centers specialist today at 816-358-3600.

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