Eye cancer, uncommon but not rare

Eye cancer is a generic term that refers to the many types of cancer or tumours that form in the tissues in and around the eye or in the eyelid or conjunctiva (the thin clear membrane that protects our eyes). It can occur in any age group.

Eye cancers are prevalent in India, especially retinoblastoma among children below the age of six, where approximately one in thousand cases are reported. Among adults, cancer of the eyelids or squamous cell carcinoma is most common while the third type of eye cancer, malignant melanoma, is rare in India and its prevalence rate is around one in 10,000 in Western countries where the skin is more exposed to the ultraviolet rays of the sun.

Types of eye-related cancer

Speaking about the main kinds of cancer of the eyes, Dr. K.V.V. Satyanarayana, professor of ophthalmology, Gitam Medical College and former faculty at Government Regional Eye Hospital, elaborates, “Though eye cancer is not very common, it is not rare either. We do see patients with carcinoma of the eyes such as retinoblastoma, malignant melanoma, and squamous cell carcinoma.”

Dr. Swathi Kaliki, head, Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute also lists the various tumours found in patients with carcinoma of the eyes. These include eyelid tumours (on the eyelids or eyebrow region), conjunctival tumours (on the surface of the eye), corneal tumours (on the front surface of the eye), orbital tumours –(occurring behind the eye and pushing the eye forward), and intraocular tumours –(occurring inside the eye in the region of the iris, retina, optic disc, etc.)

Incidences

Talking about the incidences of cancer, Dr. Satyanarayana says, “We see cases of retinoblastoma in children mainly below the age of six. It may occur, say in one in 1,000 children and the reason is mainly genetic or hereditary with cancer occurring in both the eyes and prevalent since birth. Among adults, especially among the elderly and more among women, squamous carcinoma is observed, which refers to cancer of the eyelids. This type of cancer is not seen in children.”

He adds, “Malignant melanoma is found mainly among the white-skinned Western population as they are more exposed to the ultraviolet rays of the sun and is relatively rare in India just like skin cancer.”

“Certain eye cancers may be related to smoking, virus infection, and excessive exposure to ultraviolet light. They are unlikely to be related to food habits. Certain cancers can be inherited from affected family members. While most eye cancers cannot be prevented, it is important for individuals with a family history of eye cancer to undergo routine eye screening. For those without genetic propensity, if they notice any swelling/lesion (lump) in the eyelids or on the surface of the eye or forward protrusion of the eyes or experience decreased vision, they should go for an eye examination without delay,” says Dr. Kaliki.

Symptoms

“Usually, mothers notice cat’s eye in the children or a glow in both the eyes at dark, which is a warning sign for retinoblastoma. Other symptoms are white opacity in the centre of the eye and pain and redness in the advanced stages. Malignant melanoma is usually detected during routine screening of the eyes for defective vision. A nodule may start growing in the eye. In case of squamous cell carcinoma, a nodule grows in the lower eyelid usually, which may progress into an ulcer, spread to the surrounding areas of the face if left untreated,” says Dr. Satyanarayana.

Other symptoms include bulging of the eye, swollen eyelids or a lump in the eyelid that is increasing in size, disproportion in the size of the two eyes, white reflex in the eye, occurrence of a dark patch in the eye that is getting bigger in size, a squint, redness or pain, blurred vision or partial or total vision loss.

“These symptoms can also be caused by other minor or major eye problems and are not necessarily a sign of eye cancer alone. But as soon as you notice these symptoms, it is important to get your eyes checked by a doctor and seek timely treatment and care,” advices Dr. Swathi.

Treatment

Like any other cancer, the earlier the eye cancer is diagnosed and treatment given, the outcome is better and both the life and the vision of the patient can be saved. “The treatment of cancer depends on the stage at which the patient is. Eye cancer can also spread from one eye to the other eye or to other parts of the body if not diagnosed early and treated appropriately. For smaller tumours, medical therapy or laser would suffice. Large tumours may need surgery, while aggressive tumours need removal of the eye and tumour along with chemotherapy and sometimes even radiotherapy,” says Dr. Swathi. She adds that in the past 10 years, LV Prasad Eye Institute, across its network centres, has treated over 25,000 cases of various forms of eye cancer.