Ocular tumors are metastatic tumors that occur when basal cell carcinoma spreads into organs like breasts, lungs, prostate and bowels. There are essentially two types of malign ocular tumors defined by age.
Retinoblastoma is triggered in children when cancer cells affect the light sensitive tissue of the eye. Children suffering from retinoblastoma sport a whitish glow in their pupils. Melanoma occurs due to uncontrolled expansion of cells within the eye in elderly people.
Palpable symptoms in the aforementioned ocular tumors are, blurred vision, decrease in side vision, persistent redness and pain in the eye and, loss of vision.
Types of Ocular tumors
Orbital tumors in the orbit of the eyes cause the eyes to bulge abnormally, thereby leading to Proptosis. They are primarily caused because of thyroid, lymphoid tumors, lacrimal tumors and eye diseases. Removal of tumors by surgery or, by radiation therapy is decided only after a thorough evaluation of the size, shape, and stage and the malignity of the tumor. Treatment procedures include external beam radiation therapy, if surgical means are not feasible. Post treatment, orbital radiotherapy is used to remove residual tumors.
Hemangioma is a non-metastatic benign tumor that grows within the choroid beneath the retina of the eye. If the choroidal hemangioma is located in the section of the eye associated with central vision, it can lead to drainage of the fluid, thereby resulting in retinal detachment and visual impairment. Treatment procedures like photodynamic therapy, minimal dosage of external radiation therapy and laser photocoagulation are executed to mitigate the leakage of the fluid in the eye.
Choroidal melanoma is a malignant and metastasizing intraocular tumor that occurs largely in adults due to pigmented cells in the choroid. Unlike the tumors that occur in the eye as a result of cancerous growth in other organs, choroidal melanoma has its source of growth in the pigmented cells in the blood vessels below the eyelid. Almost no symptoms are experienced by patients until they suffer from retinal detachment, obstructed vision and, haemorrhage in the eye. Surgical removal of the tumor is a risky procedure that can lead to certain cancer cells spreading around the eye, leading to a higher rate of metastasis. And, the probability of cancer cells spreading into the sclera during surgery is high. Therefore, the small sized tumors are thoroughly studied and observed for any evidence of growth in the tumor. If the tumor is medium sized, radioactive plaque therapy is used in culling the cancerous cells.
Choroidal metastatic are malignant tumors that grow rapidly around the eye. They usually originate from another source in the body such as breasts, lungs, thyroid, kidneys, GI tract and prostate glands. Leukaemia and lymphomas can cause choroidal metastasis, too. The treatment is carried out by a team of oncologists, radiation oncologists and ophthalmologists who are specially trained in oncology aspect of the eye. Chemotherapy and radiation therapy are effective in treating choroidal metastasis. In severe case of the aforementioned condition, radioactive plaque therapy or, enucleation is done.
Nevus is a nest of melanocytes accumulating on certain patches of the skin in the form of birthmarks, raised freckles and moles. A choroidal nevus initially appears to be a benign pigmented freckle on the back of the eye. Post diagnosis, it is scrutinized for four to six months, assessing its probability of developing into malignant tumor. The pigmentation of the nevus and its size is closely monitored during the stipulated period.
Conjunctival tumors grow in the outer surface of the eye, as a result of squamous cell carcinoma, lymphoma and melanoma. They may or, may not metastasize, but can spread into the orbit of the eye. Treatments include surgical removal of the squamous cells and conjunctival melanomas and, Cryotherapy.
Basal cell carcinoma is one of the common eyelid cancers that begin with benign or malign cyst formations around the eyelids. If undiagnosed, it can spread into the orbit, sinuses and into the brain, causing inflammation in the eyelids. During preliminary examination, a biopsy is conducted to assess the malignancy of the cyst. Cryotherapy and radiation therapy are effective in removal of malignant eyelid tumors. Post therapy, oculoplastic surgeries are carried out by trained oculoplastic surgeons in reconstructing the eyelids.
Symptoms of lymphoma in the eyes are gradual as the cancer cells slowly spread in the eyelids and tear ducts and finally into the eyes. Palpable symptoms include blurred vision, spots in vision, redness and swelling in the eyelids and, pain in the eye. For patients suffering from non Hodgkin’s Lymphoma, the cancer cells spread into the eye and, into the central nervous system. External beam radiation and chemotherapy are effective in treating lymphoma in the eye.
Iris tumors are benign pigmented cysts that grow inside or, behind the iris. They are monitored by the ophthalmologist with a high frequency ultrasound and a specialised slit lamp to assess the growth and size of the cyst. The diagnostic procedure aids the ophthalmologist in creating baseline reports for future, should the cysts lead to formation of malignant melanomas in the iris. Smaller cysts are surgically removed. Larger ones are removed by radiation plaque therapy.
Melanocytomas are asymptomatic benign ocular tumors that spurt on the surface of the optic disc in the eye, as a result of congenital birth defects. To an ophthalmologist’s eye, the tumor appears as a pigmented patch over the optic disc. Radiation plaque therapy is an effective treatment if the tumor is malignant.
Oculoplastic surgeons like Dr. Debraj Shome have performed many oculoplastic surgeries that involve removal of tumors from the eyes.