EYE CANCERS

You may not have ever thought about eye (ocular) cancers before but there are a number of them that your Optometrist or Ophthalmologist can detect during your annual comprehensive eye examination.  

 

BASAL CELL CARCINOMA

Basal Cell Carcinoma noted on the lower eyelid.

This is the most common type of slow growing tumor that can occur on or around your eyelids.  It usually begins as a bump that can be skin colored, red, brown or white in hue.  There is often a red/brown crater section in the middle surrounded by a pearly/translucent edge or border.

Basal cell carcinoma can grow larger but spreading throughout other parts of the body (metastasizing) is very rare.  

It is usually diagnosed through biopsy and can be treated with surgery to remove it along with some surrounding skin.  If ignored, however, it can grow around, and behind the eye which will require chemotherapy, radiation or more invasive surgery, so don't ignore any lumps or bumps on the skin near, or on your eyelids!

People who are most at risk are those who are at risk for skin cancer in other body parts:  Fair skin, elderly, history of sun tanning, burning and excessive exposure.  

 

Wearing hats and sunglasses can reduce your risk of this eyelid tumor significantly.  Think of a quality pair of sunglasses as the equivalent of "sunscreen for your eyes".  Make sure your sunwear blocks UV A and UV B rays. 

 

SQUAMOUS CELL CARCINOMA

This is another type of tumor in around the eyelid (not as common as basal cell carcinoma described above) but can spread more often (metastasize) to other organs in the body and in some cases cause death.  

The risk factors, and the prevention measures are similar to the basal cell.  Wear hats and sunglasses if out in the sun.  

A biopsy is needed to confirm the diagnosis and treatment will require surgery and reconstruction commonly performed by a Mohs surgeon.

If you see bumps on the eyelids and they aren't going away, see your Optometrist, Ophthalmologist or Dermatologist for further evaluation. 

 

RETINOBLASTOMA

This is the most common eye cancer in the pediatric population.  It looks quite obvious there's something wrong in the pupil of the eye in this photo, yet the pupil will not have that appearance unless light is shined into it.  In other words, you can't tell by looking without a light.  

It is a rapidly developing tumor in the retina cells of the eye and occurs in children.  It is commonly from a genetic defect in chromosome 13 or chromosome 13q14. 

Treatment involves radiotherapy, laser treatments or in cases of poor prognosis - removal of the affected eye.

Though the white pupil is a fairly obvious sign that something is 

Leukocoria (white pupil) in left eye, indicates possible Retinoblastoma Tumor

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wrong, not all cases will be this easy to see.  If you notice any irregular color in the pupil of the eye in photos of your children, please take them in for a comprehensive eye examination with dilation.  

The white, or opaque looking pupil will often be a sign of this condition.  As it progresses the pupil appearance becomes more obvious and the child will lose more eyesight and can sometimes develop and eye turn/strabismus problem. 

Further, a chemist from Baylor University, Bryan Shaw has developed a smartphone app which can help parents with early monitoring and hint at very subtle changes in "white pupil" / Leukocoria.

Download the android app here.

Download the itunes app for iphone here.

 

 

CHOROIDAL MELANOMA

The choroid of the eye is the second most common place in the body that you can develop a melanoma that becomes malignant (cancerous).  Overall, it is very rare - affecting 6 out of 1 million people in the U.S.  

The incidence is highest among white and lowest among black populations.  It is also more common in adults than pediatric patients.  

DIAGNOSIS OF CHOROIDAL MELANOMA

In lots of cases the presence of a choroidal melanoma won't cause any pain or affect your vision unless the fovea or macula is affected.

As you can tell from the image in this section, the melanoma often appears as a dark spot that "balloons out" from the surrounding tissue and can be detected during an eye exam with dilation and ophthalmoscopy.  

To confirm the diagnosis, your eye care professional will order other tests like Ocular Coherence Tomography (OCT), Fluorescein Angiography (FA), and Autofluorescence.

Treatment varies and will commonly require a team of Oncology and Retinology. 

OTHER CANCERS AFFECTING VISION

 

PITUITARY ADENOMA

The word "adenoma" means a benign growth from a gland tissue, so a Pituitary Adenoma means that a benign growth is occuring in the Pituitary Gland.  This can happen slowly over the course of several months to years. While small, this growing tissue may not cause any symptoms if it is not compressing other areas in the brain.

 

Because the Pituitary Gland rests close to the Optic Chiasm, the larger adenomas can compress the nerve fibers at the chiasm and cause vision loss.  

 

Because this is a very distinct location, compression in this region will cause very distinctive vision loss, called a  Bitemporal Hemianopsia.  This means that you begin to lose the side vision (right side from the right eye, and left side from the left eye) for each eye.  This can be detected during a visual field test at our eye clinic in Bellingham.

 

If the Adenoma is growing and affecting your eyesight in this manner, it must be surgically removed.   

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