Eye Cancer : Type, Symptom, Risk Factor, Diagnosis, And Treatment

An Eye cancer is cancer that begins in the eyes.Intraocular cancer is the cancer that starts inside the eyeball.Eye cancer can affect the outer parts of the eye, including eyelid, which are made of muscles, skin, and nerves.

The major parts of eye consist of

1. Eyeball (globe) is mostly filled with a jelly-like material called vitreous humor.Three layers of the eyeball are :

• Sclera is the tough, white covering over most of the outside of the eyeball.
• Uvea is the middle layer of the eyeball.It has three parts.The irish is the colored part of the eye.The choroid is a thin, pigmented layer lining the eyeball that nourishes the retina and the front of the eye with blood.The ciliary body contains the muscles inside the eye that change the shape of the lens so that the eye can focus near or distant object.
• Retina is the inner layer of cells in the back of the eye.

2. Orbit consists of the tissues surrounding the eyeball.

3. Adnexal Structures include the eyelids and tear glands.

The Types of Eye cancer

1. Cancer involving the Eyeball :

• Uveal Melanoma is melanoma of the irish, choroid, and ciliary body.
• Retinoblastoma is the most cancer type that affects the eyeball in children.It is a cancer that starts in cells in the retina.

2. Cancers of the Eyelid and surrounding skin :

• Basal Cell Carcinoma
• Squamous Cell Carcinoma
• Sebaceous Carcinoma
• Melanoma
• Merkel Cell Carcinoma
• Adnexal Carcinoma

3. Orbital Cancers :

• Orbital Lymphoma
• Orbital Sarcoma includes myxoid sarcoma, rhabdomyosarcoma, alveolar soft part sarcoma
• Orbital and Optic Nerve Meningioma
• Metastatic Tumors of the Orbit
• Other Carcinomas of the Orbit

4. Lacrimal Gland Tumors :

• Lymphoma of Lacrimal Gland
• Adenoid Cystic  Carcinoma of Lacrimal Gland
• Pleomorphic Adenoma of Lacrimal Gland
• Other Epithelial Tumors of Lacrimal Gland

The Symptoms of Eye Cancer

• Sudden loss of vision
• Blurry vision
• Losing part of the sight field
• Swelling or redness in the eye
• Flashes and Floaters
• Pigmented (dark) area on the conjunctiva
• Ulceration of the eyelid
• Loss of eyelashes
• A small, firm, raised lump with a lesion in the center on the eyelid
• Growing dark spot on irish
• Brown or pigmented lesion on the eyelid
• Sty that does not heal
• Change of eyeball position or the way of eye moves
• Double vision
• Change in the shape or size of pupil
• Bulging of eye
• Orbital or ocular pain
• Bloody tears
• Excessive tearing

Risk Factors of Eye cancer

• Race or Ethnicity
• Increasing age
• Gender
• Being white
• The color of eye
• Exposure to sunlight or tanning beds
• Certain inherited conditions, such as Dysplastic Nevus Syndrome
• Exposure to certain viruses, such as Human Papilloma Virus  (HPV)

Diagnosis

Tests and procedures are done to diagnose eye cancer.

• Medical history is about patient's health habit and past illnesses.
• Physical exam is an exam of the body to check general signs of health.
• Eye Exam with dilated pupil is an exam of the eye in which the pupil is dilated with medicated eye drops to allow the doctor to look through the lens and pupil to the retina.The are some types of eye exams.Ophthalmoscopy is an exam of the inside of the back of the eye to check the retina and optic nerve by using a small magnifying lens and a light.Slit-Lamp Biomicroscopy is an exam of the inside of the eye to check the retina, optic nerve and other parts of  the eye by using a strong beam of light and a microscope.Gonioscopy is an exam of the front part of the eye between the cornea and iris.
• Biopsy is the removal of cells or tissues by viewing under a microscope to check the signs of cancer.
• Blood Chemistry Studies is  a procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood  by organs and tissues in the body.
• Liver Function Test is a procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver.
• Ultrasound Exam is a procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes.
• Transillumination of the Globe and Iris is an exam of the iris, cornea, lens, and ciliary body with a light placed on either the upper or lower lid.Fluorescein Angiography is a procedure to look at blood vessels and the flow of blood inside the eye.Indocyanine Green Angiography is  procedure to look at blood vessels in the choroid layer of the eye.
• Chest X-Ray is an x-ray of organs and bones inside the chest.
• Computed Tomography (CT) scan is a procedure that makes a series of detailed pictures of areas inside the body, taken from different angles.
• Magnetic Resonance Imaging (MRI) is a procedure that uses a magnet, radio, wave, and computer to make a series of detailed pictures of areas inside the body.
• Positron Emission Tomography (PET) is a procedure to find malignant tumor cells in the body.

The Stages of Eye Cancer

• Stage I : Cancer is not growing into the ciliary body or growing outside the eyeball.Cancer has not spread to nearby lymph nodes.It has not spread to distant parts of the body.
• Stage II : Cancer is growing into the ciliary body and also outside the eyeball.The part of the tumor that is outside the eyeball is 5 mm or less.Cancer has not spread to nearby lymph nodes.It has not spread to distant parts of the body.
• Stage IIIA : Cancer is growing into the ciliary body and also outside the eyeball.The part of the tumor that is outside the eyeball is 5 mm or less across in size.Cancer has not spread to nearby lymph nodes.It has not spread to distant parts of the body. 
• Stage IIIB : The cancer can be any size .It is growing outside of the eyeball and the part of the cancer that is outside the eyeball is greater than 5 mm across.Cancer has not spread to nearby lymph nodes.It has not spread to distant parts of the body.
• Stage IV : The cancer can be any size.Cancer has spread to nearby lymph nodes.Or It has spread to distant parts of the body.

The Treatments of Eye Cancer

1. Surgery

• Resection is to romove the tumor and a small amount of heathy tissue around it.
• Evisceration is to remove the eye contents, leaving the sclera or the white part of the eye.
• Enucleation is to remove the eye and part of the optic nerve.
• Exenteration is to remove the eye and the eyelid.
• Iridectomy is to remove the affected piece of the iris.
• Choroidectomy is to remove the choroid layer (the vascular tissue sandwhiched between the sclera and the retina).
• Iridocyclectomy is to remove the iris plus the ciliary body muscle.
• Eyewall Resection is to remove a tumor by cutting into the eye.

2. Watchful Waiting is to monitor closely the condition of a patient  without giving any treatment until signs or symptoms appear.

3. Radiation Theraphy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.

Types of radiation therapy :

• External radiation therapy uses a machine outside the body to send radiation toward the cancer.
• Internal radiation therapy uses a radioactive subtance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

Localized Plaque Radiation Therapy is a type of internal radiation therapy that may be used for tumors of the eye.

Charged-Particle External Beam Radiation Therapy is to kill cancer cells with little damage to nearby normal tissues.

Gamma Knife Therapy is a type of stereotactic radio surgery use for some melanomas.

4. Photocoagulation is a procedure that uses laser light to destroy blood vessels that bring nutrients to the tumor, causing the tumor cells to die.

5. Thermotherapy is the use of heat from a laser to destroy cancer cells and shrink the tumor.

6. Chemotherapy is a treatment that uses drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.