Ocular Oncology

Ocular Oncology in Chattanooga, Knoxville, and the Tri-Cities Region

Ocular oncology is the study and treatment of tumors of the eye. These growths may be benign or malignant, ranging from harmless to life-threatening, impacting all parts of the eye, including its surface, interior structures, and surrounding tissue. Compared to others, eye cancers are rare, and while they may originate within the eye (primary), most are metastatic (secondary), spreading from another organ. The sooner diagnosed, the quicker the appropriate treatment can be initiated.

Types of Ocular Cancers and Tumors

Uveal Melanoma

The most common eye cancer, uveal melanomas affects the uveal layer (uvea) between the retina and sclera (the white part). Uveal melanoma is categorized into two types:
Anterior uveal melanomas develop in the eye’s front part, specifically the iris, the colored part.
Posterior uveal melanomas develop in the eye’s back part. They may include choroidal melanoma, which forms within the choroid, a pigmented tissue layer of the retina. 

Choroidal Nevus

A nevus, or birthmark, usually develops within the choroid, as brown or brown-grey patches beneath the retina. Nevi typically undergo dramatic growth in about one year and generally stay benign, but about 1 in 9,000 annual cases become malignant.

Congenital Hypertrophy of the Retinal Pigment Epithelium (CHRPE)

A congenital condition, CHRPE is a flat light gray or black spot in the retina’s outer layer. Lesions may go undetected for years, often forming on the side edges of the retina’s periphery, only being found during a retinal exam. Benign and slow-growing, patients rarely have decreased vision, unless CHRPE develops in the macula (the retina’s center).

Retinoblastoma

The main eye cancer affecting children, there are two different types of retinoblastoma:

• Congenital (heritable) retinoblastoma – Present at birth and found in all cells, patients may have a greater risk of developing other cancers throughout their lives.
• Sporadic (non-heritable) retinoblastoma– The more common type, it usually targets one eye, causing a single tumor. Slightly older children typically develop this form, and other cancer risks are lower.

Ocular Cancer Symptoms

Patients with ocular cancer are often unaware until a tumor is found during an eye exam, as there may be no symptoms, especially in the earlier stages. Symptoms may manifest later on as the cancer grows and spreads, including blurry vision, eye floaters, flashes, bulging eyes, eye irritation, and changes in your eyeball’s movement or positioning. However, these symptoms are not always a sign of cancer, as many of them can indicate other conditions. The only way to know is to get a proper diagnosis from an ophthalmologist specializing in ocular oncology.

Risk Factors for Ocular Cancers

Certain risk factors may increase your chances of eye cancer development, including:

• Age - Most eye cancers are diagnosed in those over 50 years old. However, retinoblastoma generally targets children under age 5.
• Skin color - People with fair and pale skin have a greater eye cancer risk.
• Eye color - Having light-colored eyes increases cancer risks, compared to those with darker-colored eyes.
• Inherited conditions - Your risk may be higher if you have uveal melanoma or dysplastic nevus syndrome, involving atypical-looking mole development.
• UV exposure - Ultraviolet (UV) exposure from the sun or tanning beds may increase risks.

Ocular Oncology Treatment

Specific treatment may depend on the eye cancer’s growth and aggressiveness. Monitoring alone may benefit slow-growing tumors or an uncertain diagnosis. Delaying treatment may be necessary, as it could outweigh any benefits, like causing vision loss. The most commonly recommended treatment for eye cancer is radiation therapy, specifically brachytherapy (internal radiation therapy), particularly for melanomas. In some cases, surgeries, such as an iridectomy (removal of part of the iris), may be recommended. In general, chemotherapy is not used to treat eye cancer, but may be recommended if the cancer has spread to other parts of the body.

Ocular Oncology FAQs

• What is the survival rate for ocular tumors?

  The survival rate for ocular tumors depends on several factors such as tumor size, location, and spreading rate. The 5-year survival rate for eye cancer patients is 80-85%. Intraocular melanoma, survival rates are excellent if diagnosed and treated when the cancer is still in your eyeball. Fortunately, most cancers are diagnosed and treated before they spread.

• Are there additional diagnostic tests for eye cancer?

  Besides exams and staging, your doctor may order liver imaging scans if they suspect your cancer’s spread. Your liver is the most common place for eye cancer to spread outside your eye.

• How can I prevent eye cancer?

  While eye cancer cannot be prevented, if you know you’re in a high-risk group, regular eye exams may improve your prognosis. Regular exams are especially advised if you have a family history of retinoblastoma.