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Ocular tumours
What are ocular tumours?
Ocular tumours can affect any tissue in the eye. Whether or not they are benign –which is confirmed by a biopsy–, all ocular tumours must be assessed and monitored by specialist ophthalmologists to ensure the well-being of the eye, the eyesight and, ultimately, the life of the patient is not jeopardised.
Depending on whether they originated in the eye or were the result of metastasis from cancer in another part of the body, we differentiate between primary ocular tumours and secondary ocular tumours. In women, secondary ocular tumours are often associated to breast cancer. In men, metastatic ocular tumours are often from lung cancer.
Types of ocular tumour
- Eyelid tumours: these account for half of all tumours seen by ophthalmologists and often costs of masses, nodules or bumps on the eyelids, although some are flat. They are generally benign, but must be monitored because some are not, and the malignant tumours include the most common basal-cell carcinoma.
- Orbital tumours: these are located anywhere in the eye socket (cavity in which the eyeball is housed). They are mostly benign, but they must be controlled in case they increase in size.
- Intraocular tumours: these affect the internal structures of the eye, and include the most frequent primary malignant tumour in adults, choroidal melanoma. This should not be confused with choroidal hemangioma, which also affects the same tissue (the layer between the retina and the sclera at the rear of the eye) but which is benign. Furthermore, in the case of children, the most frequent primary malignant tumour is the retinoblastoma, which occurs in the retina and can occasionally also appear in adults.
There are also tumours that affect other structures, such as the conjunctiva, the iris, the tear duct or the optic nerve.
Symptoms
Causes and risk factors
Treatment
The symptoms are very varied, depending on the location of the tumour. Those affecting the eyelids are most evident, as they often involve noticeable changes to the surface of the eyelid. However, they are often disregarded because they can initially be confused, for example, with a stye. Eyelid tumours might grow very slowly and are not often painful. Some signs of suspected malignancy are: ulceration, bleeding, irregular edges and loss of eyelashes.
Orbital tumours are often only noticed when they grow too large and, because of their size, lead to “bulging eyes” or exophthalmos, eyelid retraction (so that the eye is open too widely), strabismus and double vision, and even vision loss due to a compressed optic nerve.
This vision loss, and the appearance of retinal detachment or a haemorrhage inside the eye, might also alert of the existence of intraocular tumours that are otherwise silent and go unnoticed. This unexpected vision damage might also alert of tumours in other parts of the body, such as patients with lung cancer and ocular metastasis, which is discovered following a visit to the ophthalmologist.
Frequently Asked Questions
Eye tumors are abnormal growths of cells that can appear in different structures of the eye and its surrounding tissues. They can be benign or malignant and affect structures such as the eyelids, the conjunctiva, the orbit, the iris or the inside of the eye. Specialist diagnosis is essential to determine their nature and treatment.
Eye tumors can cause different symptoms depending on the structure affected. These may include a lesion or spot that changes in appearance, changes in vision, protrusion of the eye, changes in the eyelid, pain or vision loss. Any new or changing eye lesion should be assessed by an ophthalmologist.
Diagnosis of an eye tumor begins with a specialist eye examination. Depending on the location and characteristics of the lesion, imaging tests, photographs, ocular ultrasound, OCT or other diagnostic techniques may be needed. In certain cases a biopsy may also be necessary.
Treatment for an eye tumor depends on its type, size, location and extent. Depending on the case, surgical techniques, laser, radiotherapy, local or systemic treatments and other specialist therapies can be used. The approach must be individualized and sometimes requires collaboration between different specialists.
Eye tumors can be classified according to the structure in which they originate and can be benign or malignant. They can affect the eyelids, the conjunctiva, the orbit, the iris, the retina, the uvea or other structures of the eye.
No. There are both benign and malignant eye tumors. Determining the nature of a lesion requires a specialist assessment and, in certain cases, additional tests or a biopsy.
Yes. Different types of lesions and tumors, both benign and malignant, can appear on the eyelids. A lesion that changes in size, shape or color, bleeds or does not heal should be assessed by a specialist.
Yes. Some tumors can develop in internal structures of the eye, such as the uvea, the iris or the retina. Diagnosis requires a specialist eye examination and, depending on the case, imaging tests.
A spot or lesion on the eye can have many causes and does not necessarily mean there is a tumor. However, if a new lesion appears or it changes in size, shape or color, an ophthalmological assessment is advisable to determine its origin.
Yes. Depending on its location, size and progression, an eye tumor can cause visual changes or vision loss. Any reduction in vision with no known cause should be assessed by a specialist.
Some eye tumors can cause pain, although others can develop without causing discomfort for some time. For this reason, the absence of pain does not rule out an eye lesion.
Protrusion of the eye, known as proptosis or exophthalmos, can have various causes, including disorders of the orbit. When it is new or progressive, it should be assessed by a specialist ophthalmologist.
A change in the size, shape or color of a pigmented lesion of the eye may require a specialist assessment. You should also seek advice if there is bleeding, progressive growth or any change that is new or striking.
Depending on the location and characteristics of the lesion, photographs, slit-lamp examination, ocular ultrasound, OCT, imaging tests or other techniques may be performed. In certain cases a biopsy may be needed to obtain information about the nature of the lesion.
A biopsy is not necessary for all eye tumors. The specialist may recommend it when the characteristics of a lesion do not allow its nature to be determined through examination and imaging tests, or when tissue needs to be obtained to confirm the diagnosis.
Some eye lesions or tumors can be detected during a routine eye examination, especially when they affect visible structures of the eye. If the specialist identifies a suspicious lesion, they may request additional tests to investigate it.
The outlook and treatment options depend on the type of tumor, its location, size and extent, as well as other individual factors. Some tumors can be treated effectively, while others require more complex treatments.
No. Treatment depends on the type of tumor and its characteristics. In certain cases monitoring may be chosen, while in others surgical treatment, laser, radiotherapy, or local or systemic treatments may be needed.
In some cases it is possible to treat a tumor while preserving the eye and maintaining useful visual function, but this depends on the location, size and characteristics of the lesion. The specialist will determine the options available for each patient.
If a lesion is malignant, its type and extent need to be determined in order to establish the most appropriate treatment. The approach may require the coordinated involvement of specialists in ocular oncology and other medical fields.
Some tumors can recur after treatment. The risk depends on the type of tumor, its characteristics and the treatment given. For this reason, follow-up check-ups are important to detect any changes early.