Corneal and conjunctival tumors are malignant cancers that grow on the outer surface of the eye. The most common types of malignant conjunctival tumors are squamous cell carcinoma, malignant melanoma, and lymphoma. The good thing about these tumors is that problems can often be detected earlier than cancers hiding inside the eye, as the problem is often visible to the patient and family members. It is important that any “spot” on the surface of the eye be evaluated to be sure that there is not a malignancy there.
Squamous cell carcinomas appear as a reddish or white spot on the surface of the eye. It often has blood vessels surrounding it, and may be flat or elevated. Squamous lesions rarely metastasize, but can invade over the area affecting vision and also can invade into the orbit and sinuses. Squamous lesions are very responsive to anti-cancer eye drops and often this can cure the problem. Many of the medications to cure squamous lesions were pioneered here at Bascom Palmer Eye Institute . An advantage to the topical therapy is that it treats the entire ocular surface. Surgery is also a treatment options and is done as described above with removal and a freezing adjunct.
Malignant melanomas can start as a nevus (freckle) or can arise as newly formed pigmentation. Any pigmented spot should be evaluated to be sure that it is not suspicious. Melanomas are aggressive lesions and can metastasize. Malignant melanoma of the conjunctiva should be removed. Along with removal, a freezing treatment is also done (cryotherapy). After removal, some patients will need special anti-cancer eye drops to kill any possible “seeds”.
Lymphoma of the conjunctiva often has a “salmon” colored lesion often hiding on the surface of the eye but under the eyelid. It can be a sign of systemic lymphoma or be confined to the conjunctiva. Lymphomas of the conjunctiva are confirmed by a biopsy, and then a work up is done to see if the problem is localized only to the eye. If only on the eye, the usual treatment is external beam radiation. This is done in conjunction with our colleagues at Sylvester Cancer Center . If other parts of the eye are involved, then medications/chemotherapy is needed for the whole body.
Tests
An eye cancer specialist can determine if you have an eye cancer by performing a complete clinical examination. The examination may include asking questions about your medical history, examining both eyes, the tumor, doing an examination of the tumor, photographs, ultrasound examination, and optical coherence tomography (OCT). These imaging techniques can be very helpful in diagnosing the type of cancer that you may have and the extent of the problem. In some cases, CT scan, MRI, and a referral to an oncologist are needed. Sometimes a biopsy is needed, but in many cases our specialized examination and imaging can help provide the diagnosis so that treatment decision may be initiated.Treatments
Your doctor will recommend treatment based on your medical history and the findings from the eye examination. Malignant lesions of the cornea and conjunctiva need treatment, but benign lesions such as freckle (nevus) or a pterygium can be watched. If there are any concerns, or changes in the usually benign lesions, then treatment can be started. In these cases, the OCT can help to detect malignant changes.
Chemotherapy Eye Drops - Chemotherapy drugs are medicines that kill cancer cells. There are several types of topical chemotherapy eye drops that can be very helpful in eradicating cancer of the conjunctiva and cornea. It may be used to fully cure some squamous lesions potentially without surgery, and is also used sometimes in addition to surgery in those who undergo excisions. It is especially helpful in the management of squamous cancers of the conjunctiva and cornea as it treats the whole ocular surface. These medications can be given as eye drops and sometimes as injections around the eye. Your doctor will determine which medication is best for your eye and your type of cancer.
Cryotherapy - Cryotherapy is the use of low temperatures to treat disease. Cryotherapy is applied under local anesthesia and usually used in conjunction with surgical removal. The goal of cryotherapy is to freeze the malignant tissues in order to kill the malignant cells Cryotherapy may be recommended for conjunctival or eyelid tumors.
Radiation - Some cancers require radiation to eliminate the lesion. This may be done with a calculated directed dose onto the eye or special plaque placed on the eye. Your doctor will determine if your type of cancer needs this treatment.
Why Choose Us?
Multidisciplinary Care Teams. You’ll have your cancer evaluated and treated by a team of eye experts. They represent several specialties: ophthalmology, dermatology, ocular oncology, radiation oncology and pathology. It adds up to personalized, well-rounded care focused on giving you an optimal quality of life.
Bascom Palmer Eye Institute: Ranked #1 by U.S. News & World Report. Bascom Palmer Eye Institute is the top-rated facility in the country for the treatment of diseases and disorders of the eye, according to U.S. News & World Report. When you choose us for your eye care, you will receive the best care in the nation in a compassionate setting.
A History of Firsts. We were the first center in the country to use topical interferon drops to treat eye cancer – without biopsy or surgery. This and many other research advances ensure you the best possible cancer and eye care.
Safer, More Accurate Diagnosis. Bascom Palmer offers ultra-high frequency OCT (optical coherence tomography). This optical ultrasound diagnoses melanomas and inner eyelid (conjunctival) tumors without biopsy or radiation.