Ocular Oncology (Eye Cancers)

Ocular oncology is a branch of medicine that covers the examination and treatment of tumors occurring in or around the eye. These tumors can sometimes be harmless, sometimes potentially life-threatening. In some cases, eye tumors can cause vision loss or loss of the eye. Ocular oncologists are doctors who specialize in such conditions, namely treatments for eye cancers. (1)

Definition and Overview

Ocular oncology covers the diagnosis and treatment of benign and cancerous tumors in or around the eye. It covers the diagnosis and treatment of benign and cancerous tumors in or around the eye. The surface of the eye, eyelids, and tissues within the eye can be listed as common areas where tumors develop. They can develop from eye tissue or spread from another cancerous tumor in a different area of the body.

The types of eye tumors include 

• cancerous (malignant) 
• noncancerous (benign). 

Ocular melanoma and lymphoma, often called uveal melanoma, are two examples of malignant tumors that can develop in the eye or spread from other parts of the body (metastasis, lymphoma).

Benign tumors inside the eye, including hemangioma, can develop on their own (idiopathic). Sometimes it can occur as part of a syndrome that affects other parts of the body.

Ocular oncology doctors aim to catch ocular tumors early, prevent their spread and improve outcomes with the latest diagnostic methods and treatment approaches. (2)

Procedures

Ophthalmologists, radiologists, and medical and radiation oncologists make up the multidisciplinary team that treats patients with ocular cancer. These individuals are some of the highly qualified medical professionals.

Ocular tumors often require aggressive intervention in the form of invasive procedures that can result in severe disfigurement, thus requiring the competence of ocular specialists for cosmetic rehabilitation. (3)

When a patient is diagnosed with eye cancer, the doctor and cancer care team meet with the patient to determine treatment options. It is important to think carefully about choices and decide accordingly. It is essential to thoroughly understand the benefits, possible risks, and side effects of each treatment option. According to the American Cancer Society, the most common ocular oncology procedures include;

• Surgery for Eye Cancer

The location, size, and size of the tumor, as well as the patient's general health condition, influence the type of procedure. Patients have general anesthesia (deep sleep) for the duration of each of these procedures. After one or two days, most patients continue to be hospitalized.

The types of eye cancer surgery include Iridectomy, Iridotrabeculectomy, Iridocyclectomy, Transscleral resection, Enucleation, and Orbital exenteration.

• Radiation Therapy for Eye Cancer

Radiation therapy uses high-energy X-rays to kill cancer cells. It is a common treatment for eye melanoma. Preservation of the eye structure is the biggest advantage of this treatment method. This allows one to have a better appearance after the treatment. Radiation therapy types are Brachytherapy (plaque therapy) and External beam radiation therapy.

• Laser Therapy for Eye Cancer

Laser therapy is used when surgery or radiation is not possible. With the treatment, the eye is drawn with the help of a laser. Transpupillary thermotherapy (TTT) and Laser photocoagulation are these types.

• Chemotherapy for Eye Cancer

Chemotherapy, sometimes known as "chemo," is the use of medications to treat cancer. This treatment is particularly effective for many types of cancer that has spread. Medications can be injected into a specific area of the body, taken intravenously (through an IV line), or taken by mouth as a pill. 

• Immunotherapy and Targeted Drugs for Eye Cancer

For the treatment of advanced melanomas, scientists have recently created additional varieties of medications. Many of these medications are now used to treat skin melanomas, and some may also be beneficial in treating uveal melanomas. The two main categories of these new medications are immunotherapy and targeted medications. (4)

Candidates

People can develop various types of eye cancer, including retinoblastoma, lymphoma, melanoma, and squamous cell carcinoma. These cancer types can occasionally occur in the tissues surrounding the eyeball or spread from other body areas, including the lungs or breasts, to the eye.

Eye cancer does not always show obvious symptoms and can only be caught during a routine eye test. If the following signs of eye cancer are observed, the patient may be considered eligible for treatment.

• shadows, flashes of light, or playful lines in the vision
• blurred vision
• a dark patch growing on the eye
• partial or complete loss of vision
• swelling of one eye
• a lump on the eyelid or eye that increases in size
• eye irritation that does not go away
• rare pain in or around the eye 

These symptoms are not always indicative of cancer because they can also be brought on by less severe eye conditions. However, it's crucial to see a doctor as soon as possible to get the symptoms evaluated. (5)

Risks and Side Effects

As with any treatment, potential side effects of eye surgery include risk of 

• infection, 
• pain, 
• problems from general anesthesia 

A temporary or permanent loss of vision in the eye can occur in some circumstances, either right away or soon after surgery. The probability of the tumor returning to the orbit is quite low with total removal of the eye. (6)

Post-Procedure and Follow-up

Due to the possibility of cancer recurrence or spread even years after treatment, continuous monitoring by medical specialists is required following the completion of eye cancer treatment. Follow-up appointments are essential to identify any indications of cancer recurrence, keep track of treatment side effects, and handle any connection issues. Some adverse effects of treatment may appear years after treatment has stopped and last for a long time. Therefore, patients have the chance to ask questions or express concerns about their health state during visits with the doctor. (7)

Recovery

It is unusual for patients to experience any serious problems during the recovery period after eye surgery. The doctor provides the patients with the necessary instructions for the healing process, and if the patients follow these, the healing process is successfully completed more quickly and efficiently.  (8)

Results

Follow-up appointments should not be neglected to control healing and monitor results. It also provides information about the targeted results and progress of the treatment at these appointments.