Tumours inside the eye
The below conditions relate to tumours inside the eye. We have information on tumours found on the surface of the eye here.
A naevus is the medical terms for a freckle or mole, which are benign and very common, affecting approximately 5% of the population. They may be present for many years before they are detected and generally require no treatment. Most naevi are small and can be monitored by either your local eye clinic or optician.
Larger naevi or those that show one or more suspicious features, termed as indeterminate melanocytic lesions (IML), need regular monitoring in our eye clinic, as a small proportion can develop into a melanoma which requires treatment.
You can download a leaflet with more information here.
Melanomas develop from pigmented cells known as melanocytes in the eye, which are found in the uveal tract, involving the choroid, ciliary body and iris. Most melanomas affect the choroid with a small proportion affecting the ciliary body or iris. Uveal melanoma is extremely rare, affecting approximately fiver per million of the population per year.
The cause of ocular melanoma is unknown and is not related to skin melanoma or sun exposure. It almost always only affects one eye and seldom runs in families.
The clinical appearance will be able to determine treatment options, which may include laser treatment (photodynamic therapy), radiation treatment (plaque brachytherapy, stereotactic radiosurgery or proton beam therapy) or surgery (removal of the eye or resection).
Biopsy is not usually necessary unless there is uncertainty of the diagnosis, this is either through a biopsy from outside the eye (open flap biopsy) or inside the eye (transvitreal biopsy).
Uveal melanomas have the potential to spread elsewhere in the body (metastasis) , most commonly the liver. Therefore, surveillance screening will be required and discussed with you by the team. The risk of metastasis can be assessed by means of a prognostic biopsy, which can be discussed with the team.
For more information you can download our leaflet here
Metastases are secondary tumours that spread to the eye from a cancer elsewhere. As cancer is a common, metastases to the eye are also common, although they may only be detected if they are causing symptoms.
The commonest cancers to spread to the eye are breast, lung, bowel, kidney and prostate cancer but essentially any cancer may do so.
The patient is often aware of the diagnosis of cancer however sometimes the eye secondary may be the first sign of a problem elsewhere and further investigation, full body scan, is required to find the underlying cancer.
Depending on the underlying problem, your eye may be treated under our care. Treatment may include injections into your eye (intravitreal injections), laser treatment (photodynamic therapy) or radiation treatment through your local cancer specialist. Rarely, a biopsy is required. We may be referred you to your local cancer specialist for generalised therapy as appropriate.
Lymphomas rarely arise inside the eye and are often difficult to diagnose. A specialist vitreous biopsy usually taken from inside the eye or biopsy of the retina is required for diagnosis, rarely a biopsy is take from outside the eye (open flap biopsy). Specialist treatment is offered under our care and with help of your local lymphoma specialist, haemato-oncologist.
A haemangioma is a benign (non-cancerous) blood vessel tumour which can sometimes leak fluid and cause blurring of vision. This commonly affects the choroid and if symptomatic can be treated with laser therapy, photodynamic therapy (PDT).
Bleeding into the eye is not uncommon and because it is dark in colour it may resemble a melanoma. In general, the two conditions can be distinguished using ultrasound and if haemorrhage is suspected we may recommend observation to allow the blood to disperse and confirm the diagnosis.