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Understanding Eye Tumours: Types, symptoms, causes and treatment

Dr. Ajay KohliJun 23, 2024

Our eyes are incredibly precious, serving as our windows to the world. They not only capture visual stimuli but also relay vital information to our brains. Protecting them is paramount. When it comes to eye health, tumours can pose significant risks. Whether benign or malignant, these growths can impact various structures within the eye.

Given their sensitive location, early detection and treatment are crucial. Swift action can help prevent unforeseen consequences, whether it's vision impairment or even life-threatening complications. Therefore, prioritising regular eye exams and seeking medical attention for any concerning symptoms is essential.

By staying vigilant and proactive, we can safeguard our invaluable assets and ensure optimal eye health for a lifetime.

Contents

What is an Eye Tumour?
Are eye tumours the same as eye cancer?
Signs and symptoms of Eye Tumour
What are the causes and risk factors of Eye Tumours?
Types of Eye Tumours
Cancerous Types of Eye Tumours
Treatment for Eye Tumour
Diagnosis of Eye Tumour
How can I prevent Eye Tumours?
The right time to speak to a doctor
Frequently Asked Questions (FAQs)

What is an Eye Tumour?

An Eye Tumour, also called an ocular tumour, is a mass of cells in any part of the eye that grows and divides uncontrollably. They may be benign or malignant or originate in (primary) or outside of the eye (secondary). In the majority of cases, Eye Tumours are secondary cancers, usually spreading from the lungs, breasts, or prostates and reaching the eyes. Melanoma, particularly uveal melanoma, is a common malignant adult tumour that typically develops in the pigmented cells around the eyes. Retinoblastoma, on the other hand, is a type common in children that affects the retina, the most light-sensitive tissue. Because both these tumours are aggressive, melanoma can quickly become cancerous.

Are eye tumours the same as eye cancer?

When faced with a diagnosis of an eye tumour, the initial fear often revolves around the possibility of cancer. However, it's crucial to understand that not all eye tumours are malignant. In fact, many are benign and do not metastasise to other parts of the body. One of the most prevalent benign ocular tumors is the choroidal nevus, which typically poses little threat to vision or overall health. Another type, the choroidal hemangioma, is a vascular tumour that, while benign, may cause complications depending on its location and size.

While benign tumours generally do not lead to vision loss, their impact can vary based on their position within the eye. If situated in the macula, the central region of the retina responsible for detailed vision, these tumours can disrupt visual acuity and lead to changes in eyesight. Such alterations can significantly affect daily activities, emphasising the importance of timely diagnosis and appropriate management.

Although the prospect of an eye tumour can be alarming, understanding the nature of these growths, whether benign or malignant, is crucial for informed decision-making and effective treatment planning. Regular eye examinations and prompt medical attention for any concerning symptoms are essential for preserving vision and overall ocular health.

Signs and symptoms of Eye Tumour

Patients with Eye Tumours rarely exhibit symptoms unless the tumour has grown in certain parts of the eye and is detected during routine eye inspections. But if symptoms develop, they may vary depending on whether the tumour is cancerous or not. For both adults and children, the symptoms visible are contrasting. In adults, the following symptoms of eye cancer include the following.

Bulging in one eye, usually without pain
Swelling of the eye
Seeing flashes of light, or floaters in the vision
Growing spot in the iris
Blurred vision, haloes, and shadows around images, especially of bright light
Change in the size or shape of the pupil
Iris discolouration
Losing part of your line of vision
Redness or burning in the eyes
Deviation in the direction your eye moves

While in children, the common symptoms are as follows.

Cross eye
Whitened pupil
Glaucoma
Severe pain and redness

What are the causes and risk factors of Eye Tumours?

No one knows for sure why Eye Tumours form, yet scientists have long suspected faulty genes that probably pass on to newborns from birth. An Eye Tumour develops when errors set in the DNA of healthy cells. Such errors accumulate in the cells unless rectified, causing them to grow and divide erratically. However, what triggers these DNA errors are distinct for different types of Eye Tumours.

For benign tumours, triggers usually are as follows.

Certain occupations like welding and cooking
History of skin cancer
Viral infections
Ageing
Large, pigmented lesions or moles

The link between sunlight exposure and intraocular melanoma is unclear and needs further study. As for malignant tumours, which are more prevalent after the age of 50, the following suspected triggers appear to increase a person's risk.

Blue or green eye colour
Fair skin
Exorbitant outdoor activities in the sun
Gender (males are more vulnerable than females)
Certain inherited skin conditions like dysplastic nevus syndrome, BAP1 cancer syndrome, or uveal brown spot (also called oculodermal melanocytosis)
Presence of moles and freckles on the eye or skin
Mutation in certain regulatory genes (like GNAQ and GNA11 genes)

Types of Eye Tumours

Since most Eye Tumours, despite their rarity, are malignant, they are classified according to the type of cell they originate from.

Uveal melanoma: This type of Eye Tumour is aggressive cancer that commonly affects adults. It arises from the pigment cells (melanocytes) of the iris, the ciliary body, or the choroid ,collectively called the uvea, that gives colour to the eye. Melanomas that arise in the choroid are most common; those that originate in the ciliary body are less common, and the ones that occur in the iris are rarest.
Choroidal Hemangioma: This rare benign tumour does not spread to other parts of the eye or to a distant location in the body. Furthermore, these tumours are asymptomatic and are usually found during routine eye exams.
Retinoblastoma: It's an aggressive malignant Eye Tumour that originates from the immature retinal (light-sensitive) cells and is more likely to affect children under the age of 5.

In exceptionally rare cases, melanoma can also occur on the eyelid or thin lining over the white part of the eye (the conjunctiva).

Check out: How to create ABHA Card

Cancerous Types of Eye Tumours

Malignant eye tumours encompass a spectrum of conditions that arise from various types of cancer, each with distinct characteristics and implications for vision and overall health. Understanding these malignancies is crucial for early detection, effective treatment, and optimal patient outcomes.

Uveal melanoma stands out as one of the most prevalent forms of intraocular cancer. Originating in the uvea, which comprises the iris, ciliary body, and choroid, this melanoma primarily affects adults aged 60 and above. While relatively rare, with an annual incidence of 1,500 to 2,000 cases in the United States, uveal melanoma poses significant risks due to its potential for metastasis. Treatment typically involves a combination of approaches, including surgery, radiation therapy, and targeted therapies, tailored to individual cases and aimed at preserving both vision and life.

Intraocular lymphoma represents another rare yet serious ocular malignancy. This form of cancer originates within the eyeball, often presenting diagnostic challenges due to its uncommon nature and varied clinical manifestations. Prompt diagnosis is critical for initiating appropriate treatment strategies, which may include chemotherapy, radiation therapy, or immunotherapy, depending on the extent and characteristics of the disease.

Eyelid tumours encompass a range of malignancies, with basal cell carcinoma being the most common. Other types, such as malignant melanoma, sebaceous cell carcinoma, and squamous cell carcinoma, also occur, necessitating surgical excision and, in some cases, adjunctive therapies to prevent recurrence and preserve eyelid function and aesthetics.

Conjunctival tumours, which develop on the eye's surface, encompass lymphomas, melanomas, and squamous carcinomas. These tumours can present challenges in diagnosis and management, often requiring a multidisciplinary approach involving ophthalmologists, oncologists, and pathologists. Treatment may involve surgical resection, topical therapies, or localised radiation tailored to tumour characteristics and patient factors.

Lacrimal gland tumours arise within the tear glands, posing challenges in both diagnosis and treatment due to their location and potential for adjacent tissue involvement. Management typically involves surgical resection, sometimes followed by adjuvant therapies to minimise the risk of recurrence and preserve tear production and ocular function.

Retinoblastoma, the most common childhood eye cancer, originates in the retina and predominantly affects children under the age of 5. Often associated with mutations in the RB1 gene, retinoblastoma manifests as leukocoria or a white pupil, prompting early detection and intervention. Treatment may involve a combination of chemotherapy, focal therapies, and sometimes enucleation, with a focus on preserving vision and minimising long-term sequelae.

Treatment for Eye Tumour

Eye Tumours can be treated in various ways depending on their size, type, stage, and the patient's preferences. The main goal is to save vision whenever possible. For tiny, non-spreading freckles and growths, treatment isn't usually indicated, and your doctor may just "wait and watch" them for possible changes. However, a cancerous Eye Tumour requires a quick and planned intervention and depending on your diagnosis; treatment usually involves the following.

Surgery (resection or enucleation): This is the most common option for patients with large, spreading tumours that interfere with their vision. And that most patients require prosthetics after surgery for better cosmetic results.
Local resection: It involves removing the cancerous portion of the eye, for example, iridectomy, eyelid resection, etc.
Radiation therapy: This treatment destroys tumour cells without harming surrounding tissues and is used when surgery does not remove the tumour or when the tumour recurs. Typical options include proton beams or radiation plaques (brachytherapy), which deliver accurate doses, minimising collateral damage. However, vision loss is a problematic adverse effect of this treatment.
Laser therapy: This non-invasive procedure destroys the blood vessels that carry nutrients to the tumour cells, causing them to shrink and die. The treatment has fewer side effects than radiation therapy and surgery.

Diagnosis of Eye Tumour

Your doctor may perform these tests along with a physical examination to confirm a tumour diagnosis.

Eye exam: Examination of the eye is often the most important first step in diagnosing eye melanoma. The doctor will ask about your symptoms and check your vision and eye movement. They may also look for the sign of a tumour inside the eye using an ophthalmoscope.
Imaging tests: If the doctor suspects the tumour is cancerous, imaging tests such as ultrasounds or CT and MRI scans of the head will help create detailed pictures, which will allow your doctor to:

find out whether cancer has already spread to other nearby organs, especially the brain
determine whether treatment is working
check for signs of cancer returning after treatment

Biopsy: A biopsy involves removing a small piece of the tumour and examining it in the lab for cancer cells. It is not only useful to check for certain gene mutations (changes), but it is also useful to choose targeted drugs for cancer treatment.
Blood tests: It is usually done after the diagnosis has been made to determine how well your liver is working.

How can I prevent Eye Tumours?

Although several measures are suggested to reduce your risk of skin melanoma, some tips are also effective in reducing the risk of Eye Tumours/cancer. These include the following.

Do not expose yourself to intense sunlight
Wear protective clothing and a wide-brimmed hat
Put on sunglasses that block 100% of UVA and UVB rays
Make smart food choices and eat fruits and vegetables. Also, limit your consumption of processed foods, red meat, and alcohol.
Take steps to reduce psychological stress that can decrease a tumour's ability to grow and spread

The right time to speak to a doctor

It is essential for individuals to seek medical attention if they experience any concerning symptoms related to their eye health. Symptoms such as persistent eye pain, changes in vision, unusual growths, alterations in the appearance of the eye, or the development of new blood vessels warrant prompt evaluation by a healthcare professional.

Attempting to self-diagnose or dismiss symptoms related to eye health can lead to delays in the diagnosis and treatment of potentially serious conditions, including various types of eye cancer.

Consulting a doctor allows for thorough examination, accurate diagnosis, and appropriate management to address any underlying issues and preserve both eye health and overall well-being. Therefore, anyone experiencing symptoms should prioritise seeking professional medical care for proper evaluation and guidance.

Frequently Asked Questions (FAQs)

Here’s a list of common questions and their answers related to Eye Tumours.

What are the warning signs and symptoms of Retinoblastoma in children?

Retinoblastoma is a rare cancer, so its symptoms are also rarely reported. However, if parents want, they can notice for:

white discolouration at the centre of the eye
redness and swelling of the eye
acquired squint
watering of the eye

Who is at risk of developing an Eye Tumour?

People between 50 and 70 years of age are at a higher risk of developing Eye Tumours. The condition is even more likely to occur in individuals with atypical moles syndrome, also known as dysplastic nevus syndrome, who often have a higher risk of developing skin cancer, with over 100 moles on their body, some of which are abnormal in size and shape.

What is the prognosis for an ocular tumour?

Despite their rarity, ocular tumours are aggressive cancers. Nearly half of patients with this type of tumour develop metastases within 10 to 15 years of diagnosis, regardless of the advancement in treating primary intraocular melanoma. Still, the good news is if the tumour is detected and treated early, the relative 5-year survival rate is about 85%, according to the American Cancer Society.

Will my Eye Tumour affect my brain?

It is possible. When you have an Eye Tumour, the drop in vision affects your ability to stimulate your brain, causing a decline in your cognitive functions.

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.