Monthly Archives: May 2020

Eye Cancer

Eye cancer is a disease in which cells in the surrounding eye or tissue organs grow rapidly, uncontrolled, malignant, and can spread to other parts or organs of the body. As it grows and spreads, the cancerous cells may damage the surrounding normal cells.

Eye cancer is a rare disease. Eye cancer can occur in three main parts of the eye, i.e. eyeballs (globe), Orbita (the tissues surrounding the eyeball), and eye accessories (eyebrows, tear glands, and eyelids).

Eye cancer can be derived from eye cells as well as from cancer in organs or other body parts that spread to the eyes. Eye cancer derived from the eye part is called primary eye cancer, while the eye cancer of other organs is called secondary eye cancer.

Types of eye cancer

Based on the original network, eye cancer can be divided into several types, namely:

  • Intraocular melanoma

Intraocular melanoma is the most common type of eye cancer. The melanoma can of pigment-producing cells (dyestuffs) or melanocytes located in the uvea tissues. Intraocular melanoma appears most often in the coroid, but it can also occur in the iris (rainbow membrane) tissues.

  • Intraocular lymphoma

Intraocular lymphoma is a type of eye cancer derived from cells in the lymph nodes in the eye. Intraocular lymphoma belongs to the non-Hodgkin lymphoma group.

Patients with intraocular lymphoma generally have a disease that causes weak immune system, such as HIV/AIDS. Intraocular lymphoma also often appears in conjunction with lymphoma in the central nervous system called primary central nervous system (PCNSL).

Retinoblastoma

Retinoblastoma is an eye cancer in children. Retinoblastoma arises from the occurrence of gene mutation in the retina causing the retinal cells to divide rapidly and spread to the eye tissues and other parts of the body. Retinoblastoma can occur in either one or both eyes.

In addition to the three types of eye cancer above that occur in the eyeball, eye cancer can also occur in the Orbita and the Eye accessories section. Some types of cancer in the Orbita network and the eye Accessories network, among others:

Eyelid cancer, a variant of skin cancer, such as basal cell carcinoma or squamous cell carcinoma
The Orbita cancer, which is a cancer that occurs in the muscles of the eyeball and connective tissue around the eyeball (rhabdomyosarcoma)
Conjunctival melanoma, which is the cancer that occurs in the conjunctival membrane that lines the eyelids and eyeballs, usually this cancer looks like a black stain in the eyes
Tear gland cancer (malignant mixed ephitelial tumors), which is a tear gland cancer derived from the cells of the gland that can spread to other parts of the body

Causes of eye cancer

Not known for certain causes of eye cancer. However, suspected eye cancer arises as a result of gene mutation in the eye tissues, especially the genes regulating cell growth.

Despite the unknown cause, there are factors that can increase the risk of eye cancer, namely:

  • Age over 50 years old
  • White-skinned
  • Has a bright eye color, such as blue or green
  • Having a family with an intraocular melanoma history
  • Have abnormalities or a history of certain abnormalities, such as having a lot of moles (dysplastic nevus syndrome) or black patches on the eyes (nevus of Ota)

Some studies have stated that exposure to harmful chemicals, exposure to sunlight, or exposure to ultraviolet lamps is also related to the occurrence of eye cancer. In addition, some types of work, such as welders, are also thought to increase the risk of a person being affected by melanoma.

Eye Cancer Symptoms

The symptoms of eye cancer differ depending on the type of cancer suffered. Symptoms may resemble symptoms of other eye conditions or diseases. Sometimes, eye cancer may also not cause any symptoms at first.

However, in general there are some symptoms that can signify eye cancer, namely:

  • There are dark spots on the iris
  • Vision Disorders
  • Field Refinement
  • See things like flying floaters, stripes, or freckles.
  • See Flashes of light
  • Changes in pupil size and shape
  • Strabismus or squint
  • One eye looks more prominent
  • A bump on the surface of the eye, eyelid, or around the eyes
  • Eye pain
  • Red Eye or irritation
  • Conjunctivitis

In children with retinoblastoma, they will look like “cat eyes” or white patches when their eyes are exposed to light.

When to go to a doctor

Since the symptoms of eye cancer are not specific and can resemble symptoms of other eye conditions or diseases, it is advisable to conduct a doctor’s examination if you experience symptoms such as those mentioned above, especially if the symptoms do not subside after 2 weeks.

Routine examination to the doctor is highly recommended if you have any factors that may increase the risk of developing eye cancer. The examination should be done once a year, so that eye cancer can be detected as early as possible.

Eye Cancer Diagnosis

The doctor will do the question and answer about the complaints and symptoms of the patient, including from when the symptoms arise and what can trigger or relieve symptoms, as well as the general medical history of the patient.

The doctor will also perform an eye exam with the help of tools, such as ophthalmology, slit lamp, and lens gonioscopy, to see eye conditions. This examination aims to determine the ability of eye vision, the movement of the eyeball, and the condition of the eye veins.

If the results of the examination indicate the possibility of eye cancer, some supporting examinations can be done to confirm the diagnosis, among others:

  • Scans, such as eye ULTRASOUND, CT scans, or MRI to determine the location and size of cancer cells
  • Biopsy, to sample a cancer-eye tissue that is suspected to be examined in a laboratory
  • Lumbar puncture, to detect whether intraocular lymphoma cancer has spread to the brain or spinal cord.

Eye Cancer Treatment

The chance of eye cancer cure depends on the size of the tumor, the severity of the condition, and the area and the cancer eye parts. In some patients, relapse can also occur after treatment and is declared cured.

Treatment of eye cancer aims to maintain the function of the eye, preventing the occurrence of the spread of cancer cells to other parts of the body, and prevent recurrence after treatment. Some methods that can be done include:

1. Operation

The type of operation performed depends on the location and size of the existing cancer network. During surgery, patients are usually given total anaesthesia. Specifically, the types of surgery that can be done to treat cancer are:

  • Iridectomy, which is the removal of part of the iris to treat small-sized iris melanoma
    Iridotrabulectomy, which is the removal of the part of the iris along with a small portion of the eyeball to treat the melanoma
    Iridosikletomy, which is the removal of the iris and part of the ciliary to treat Iris melanoma
    Transkleral resection, which is the removal of melanoma cancer that occurs in the choroid or the body of the ciliary
  • Enukleation, which is the removal of the entire eyeball in large melanoma or in patients who have lost sight
  • Eye excitation, i.e. eyeballs and some other parts around it, such as eyelids, muscles, nerves, and other tissues in the eye cavity

2. Radiotherapy

Radiotherapy is a treatment done by firing high-energy X-rays in cancer tissues. With radiotherapy the risk of losing or eyeball damage and vision loss can be reduced. The two types of radiotherapy that can be administered are:

  • Briterated, this procedure is carried out by inserting a small-sized radioactive plate in the surrounding eye area close to the cancer tissues
  • External radiotherapy, this procedure is performed by firing X-rays to the eye, but at risk of damaging other healthy tissues around the cancer

3. Laser Therapy

Laser therapy serves to destroy cancer tissues using laser beams. Laser therapy is usually used in patients with intraocular melanoma and small retinoblastoma, but is not recommended for people with intraocular lymphoma.

4. Chemotherapy

Chemotherapy is a method of eye cancer treatment using chemical medicines. Chemotherapy can be injected directly into the eye area (intraocular), into the cerebrospinal fluid (intrathecal), or administered through an infusion. Chemotherapy can be administered to patients with retinoblastoma, or intraocular lymphoma.

5. Medicine

Some drug immunotherapy and targeted therapeutic medications can be a treatment option, especially if chemotherapy drugs are not effective for this type of eye cancer that is handled. Immunotherapy drugs, which are pembrolizumab and ipilimumab, have been shown to overcome melanoma.

6. Cryotherapy

Cryotherapy is a method of cancer treatment by freezing the cancer tissue. Cryotherapy can be given to small retinoblastoma sufferers.

Eye Cancer Complications

Complications that can occur due to eye cancer include:

  • Vision or blind loss
  • Glaucoma
  • Spread of cancer cells to other parts of the body (metastases)

Eye Cancer Prevention

Because not all types of eye cancer are known for the exact cause, it is quite difficult to prevent the occurrence of eye cancer. The best thing that can be done is to avoid factors that can increase the risk of this condition. Some of the things that can be done are:

  • Avoid exposure to sunlight or ultraviolet rays by wearing UV-protected glasses when the sun is blazing
  • Preventing the occurrence of HIV infection, which is one of the factors that can increase the risk of intraocular lymphoma
  • Conducting early examination in children if a family member has a history of retinoblastoma