Can Cancer Affect the Eye?

By Michael J. Dodd, MD

Maryland Eye Associates

. http://marylandeyeassociates.com

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Can Cancer Affect the Eye?

During Cancer Awareness Month it is useful to consider the entire body. Most of us are aware that cancer can affect almost any organ. But we usually do not think of the eye as being susceptible. In this article we will review some potential ways cancer can affect your eyes and vision.

Cancer can broadly be defined as a rapid, abnormal growth of cells within a specific body tissue or organ. The abnormal cells emit toxins and spread to healthy organs eventually leading to death of the individual. Fortunately, today most cancers are treatable if diagnosed early. Still, cancer is the second leading cause of death in the United States.

The most common cancers that affect the tissues around the eye are skin cancers. Sun exposure is the biggest risk for skin cancers. Nearly everyone is aware that skin protection is vital to reduce the likelihood of cancer. There are many very effective sun block lotions available today. However, most people do not specifically apply sun block to the eye lids. UV blocking sunglasses are protective to some extent, but do not replace sun block.

Therefore, as ophthalmologists, we frequently see skin lesions on the lids that require biopsy to diagnose whether they are benign or malignant. Three common skin cancers can affect the lids basal cell carcinoma, squamous cell carcinoma and the dreaded malignant melanoma. Basal cell cancers are the easiest to treat. They are slow growing are noticeable as slightly elevated round or oval tiny mounds. They spread only if not diagnosed early. Surgical excision is curative.

Squamous cancers are more aggressive and can spread. They often present as a non-healing sore. Early surgery prevents metastasis.

Malignant melanomas are typically darkly pigmented flat spots that grow rapidly. They must be excised early to prevent spread to other organs. If any of these cancers is large by the time of surgery, plastic lid reconstruction or even lid replacement may be required. If you see any suspicious spots on your eyelids, be sure to seek medical attention.

It is also possible to have cancers start on the eyeball or inside the eye. The coating on the white of the eye is the conjunctiva and is susceptible to sun light much like the skin. The same types of cancer that affect the skin can occur on the conjunctiva. Surgical excision is usually curative.

Tumors can grow inside the eye itself. Although they are rare they can be devastating and cause blindness and even death if they spread through the bloodstream. The most common is Choroidal Melanoma. The choroidal tissue is the thin pigmented layer beneath the retina. Pigmented nevi (benign flat tumors) can start in the choroid and slowly grow. They can become more aggressive and become elevated converting into a malignant melanoma. Choices for treatment include removal of the eye and more recently treatment with radiation.

Finally, there are occasions where malignant tumors from elsewhere in the body can metastasize through the blood stream to the retina or choroid. These present as elevated masses when the doctor inspects the back of the eye. They can resemble malignant melanomas. Radiation is usually palliative.

There are other rare cancers that can affect the eyes. Prevention is the best medicine. For patients under 40 years of age, a check up every 3-4 years is recommended. For those between 40-60, every two years and for those over 60 once a year is suggested.