Cancers of the eye and the surrounding structures (ocular oncology) can affect all age groups, starting from young children to elderly individuals. The treatment of eye cancer requires a specialised team of doctors, nurses, low vision and rehabilitation facilities, as well facilities for ocular pathology services, genetic counselling and prosthetic rehabilitation.
The Integrated Eye Cancer Treatment center at Dr. Shroff’s Charity Eye Hospital is the first of its kind in North India, with dedicated facilities for treatment of various eye cancers under one roof. In keeping with the hospital’s mission and vision of providing quality care to all, the center has tied up with likeminded NGOs and philanthropists to provide highly subsidised treatment to patients from the underprivileged sections of society. Annually, the center treats about 400 patients with various eye cancers, referred from across the country as well as identified through the primary and secondary care network of the hospital.
What are the signs of eye cancer?
-Bulging or outward protrusion of one eye
-A pigmented patch which is growing in size
-A lump or mass on the lids which has started increasing in size
-Blurring of vision, shadows or flashes, wavy lines in the vision
-Loss of vision ( partial or total)
-Localised congestion or redness in the eyes
The various types of eye cancers treated at the centre include:
Retinoblastoma: Retinoblastoma is the most common intraocular malignant tumour in children. This tumour is most commonly seen in children less than 5 years of age, where it is seen as a white reflex (also called cat’s eye reflex) involving one or both eyes. This type of tumour develops from the retina and grows either inside the eye (endophytic) or outside the eye (exophytic). While timely detection and prompt treatment can save not only the eye and vision, delayed diagnosis and treatment can make this cancer spread to the brain and other parts of the body, and prove to be fatal. Retinoblastoma can be treated by various modalities like intravenous chemotherapy, laser and cryotherapy, enucleation surgery, and radiotherapy, as well as newer treatment modalities like intravitreal chemotherapy and intra-arterial chemotherapy (IAC).
Melanoma: Melanoma starts in pigmented cells of the eye called melanocytes and can arise from either iris (coloured part of the eye), choroid (pigmented nourishing layer of eye that nourishes retina), or ciliary body (contains muscles which help in changing focus of lens for distant and near objects). It can also involve the conjunctiva, where it is seen as a dark pigmented patch over the surface of eye. Melanomas are usually aggressive malignant tumours, usually affecting the elderly, and if not detected and treated on time, can spread to other parts of the body and prove fatal. Melanoma can be detected by a detailed examination of the eye by an eye surgeon with special training in diagnosis and treatment of eye cancer (ocular oncologist).
Lymphoma: Lymphoma is another malignant tumour which can involve the eye. Most commonly it’s the non-Hodgkins lymphoma originating in white blood cells of the lymphatic system involving the eyeball. They can develop from the retina (light-sensitive tissue of eye), the vitreous (jelly-like fluid inside the eye), or the optic nerve at the back of the eye.
Eyelid tumour: There are various forms of cancers involving the eyelid, like sebaceous gland carcinoma, squamous cell carcinoma, or basal cell carcinoma, which are present as a mass in the eyelid and marked by progressive increase in size. Complete removal by surgery under frozen section margin control is a preferred modality of treatment.
Orbital tumour: Orbital tumours can be benign or malignant, or they can be primary or metastatic. The most common benign tumour involving the orbit is cavernous hemangioma, affecting young or middle-aged adults. Other types of orbital tumours are meningiomas, schwannomas, lacrimal gland tumours, optic gliomas and sarcomas.
Orbital tumours are present as progressive bulging and/or displacement of the eyeball, with or without a palpable or visible lump around the eyeball. Most orbital tumours are treated by surgical removal, while additional treatment like
chemotherapy and radiotherapy may be required in cases of aggressive malignant tumours.
Conjunctival carcinoma: Carcinoma of the conjunctiva and cornea (visible outer layer of the eyeball), also known as OSSN (ocular surface squamous neoplasia), is a common tumour of the eye. This tumour is usually visible as a reddish/pinkish lump. Treatment is usually by a simple surgery or with topical chemotherapy medications.
Secondary tumours (metastasis): These are malignant tumour cells from other parts of the body which involve the eye; most commonly they involve the choroidal layer since it is the most vascular structure of the eye. The common eye metastasis is from breast cancer (in females) and lung cancer (in males).