Ocular Oncology

The common eye cancers are Retinoblastoma in children and Choroidal melanoma in adults.

Eye Cancer in children

Retinoblastoma is usually seen in children under 5 years and has an incidence of around 1 in 15000 live births in India. It can be unilateral or bilateral (usually familial or hereditary). It is seen as a white reflex in the eye of the child. As with all cancers, untreated will lead to death of the child. However, with modern techniques and newer chemotherapeutic drugs, the survival rate has improved from 60% to almost 95%.

Other cancers around the eye are Rhabdomyosarcoma & Neuroblastoma

Eye cancer in adults

Choroidal melanoma is the most common primary intraocular malignancy in the adult population, Choroidal metastasis is the most frequent. Though Uveal Melanoma is not so common (having an age-adjusted incidence of 5.1 per million) once it spreads out of the eye,  it is extremely difficult to treat and can be fatal.

The other eye cancers are Eyelid cancers, seen as large bumps, which can grow rapidly. These may be Sebaceous Cell, Squamous Cell or Basal Cell carcinoma.

Ocular surface squamous Neoplasia (OSSN) and other conjunctival tumours can also be seen in young adults as well.

Choroidal Metastases, which are cancer deposits in the eye secondary to cancer in other parts of the body may also be seen. Especially in cases of Breast and Prostate carcinoma ( check)

Yes, eye cancers are treatable and timely intervention with newer techniques has improved the survival rate to more than 90% in many cases.

However, early detection & prompt management is key to a good outcome: preservation of vision and saving the life

In large tumours (advanced disease) we would need to remove the eye and tumour within it. The eye and vision can be saved if the disease is caught early and the tumor is small. For conditions like retinoblastoma, early screening in cases with a family history is advised. Uveal melanoma & choroidal metastases may be picked up on routine fundus screening, it would be prudent to get regular eye check ups after the age of 50.

Some of the eye saving techniques include

• Plaque Brachytherapy
• Chemotherapy (intravenous and targeted)
• Specialized Radiation techniques using Cyber-knife
• Super-selective chemotherapy ( intra-arterial chemotherapy) for Retinoblastoma
• Laser or cryotherapy of small retinal lesions
• Excision with cryotherapy for conjunctival lesions
• Tumour excision with reconstruction +/- Frozen section guidance

Other tumours that can be seen around the eye are

Orbital tumour: such as Cavernous hemangioma, Schwanomma, Meningioma, Optic nerve glioma etc

Lacrimal Gland Tumours: such as Pleomorphic adenoma & Adenocarcinoma

of  the Lacrimal gland