Eye Cancer

See also: Ocular Oncology Team and Ocular Melanoma Research

Emory Eye Center's eye cancer specialists provide comprehensive care for patients with ocular cancers. Our caring physicians and affiliated professionals are committed to delivering the highest level of treatment and compassionate care while engaging in rigorous research for cures for certain types of ocular cancers.

As one of only a few ocular oncology subspecialties in the country, we offer the latest medical, surgical and radiation treatments for adult and pediatric patients with eye malignancies.

Clinical care

Although eye cancers are considered to be rare, they do happen. Our Ocular Oncology Team of ocular oncologists, ocular pathologists and scientists is uniquely poised to expertly diagnose and compassionately treat patients with these diseases.

Members of the team evaluate and treat patients with eye, eyelid, and orbital tumors, including ocular melanoma, retinoblastoma, lymphoma, and other tumors of the eye and surrounding tissue.

Being part of the Emory Healthcare network, our eye cancer specialists collaborate with radiation oncologists, medical oncologists and physicists at Winship Cancer Institute and the Cancer Center at Children’s Hospital of Atlanta to provide state-of-the art clinical care and treatment options for patients. Oncologic care, medical, radiation, surgical and laser treatments of periocular tumors–-skin tumors around the eye–-are coordinated with other Emory Healthcare services, including dermatology, neurosurgery, and head and neck surgery.

What is eye cancer?

Eye tumors are either primary tumors originating within the eye or associated structures or secondary tumors caused by cancers that have spread from other parts of the body. Both may involve the eye, eyelid, orbit and lacrimal glands.

Some of the most common eye cancers include:

• Choroidal melanoma
  The most common intraocular (inside the eye) tumor in adults and does not come from another cancer in the body. The tumor can be in the iris or in the choroid, the layer of blood vessels between the retina and the white of the eye, the sclera. Symptoms are often silent and found by routine eye exams. A nevus is a benign growth but must be watched to be sure it doesn’t change into a melanoma.
• Choroidal hemangioma
  A tumor comprised of blood vessels, which can grow in the choroid, the blood vessel layer beneath the retina.
• Conjunctival tumors
  Malignant cancers growing on the outer surface of the eye, including squamous cell carcinoma, malignant melanoma, lymphoma and carcinoma-in-situ. They are managed by physicians in the Corneal and External Disease division: R. Doyle Stulting, MD, PhD, and J. Bradley Randleman, MD.
• Eyelid/Orbital tumors
  These tumors can be benign cysts, inflammation or malignant skin cancers, including basal cell, squamous cell, meibomian gland, etc. carcinomas. The tumors are evaluated and treated by the physicians in the Oculoplastics division: Drs. Ted Wojno and Brent Hayek. The tumors (both benign and malignant) occur in children and adults. Examples of childhood tumors are rhabdomyomas and dermoids and adult tumors include hemangiomas, lymphomas, lacrimal gland tumors and cysts.
• Iris and ciliary body tumors
  These tumors grow within the iris (colored part of the eye) or behind the iris (ciliary body). Some are cysts or a nevus (benign), though malignant melanomas can occur in this area.
• Lymphoma/leukemia
  Tumors can appear in the eyelid tissue, tear ducts and the eye itself. In patients with non-Hodgkins lymphoma, symptoms may appear in the eye before they are noted elsewhere and are managed by the Oculoplastics division.
• Retinal tumors
  Retinoblastoma (RB), a malignant tumor of the retina (the back of the eye), affecting mostly children, and other tumors of the retina, the innermost layer of blood vessels and nerves that serves as the “film” of the eye.

Diagnosis

Members of Emory Eye Center's Ocular Oncology Team evaluate the tumor and determine the best possible treatment for each patient. Diagnostic options may include a thorough eye examination, an ultrasound (echography), photography (fluorescein angiography and/or fundus photography, ocular coherent tomography (OCT), and additionally may use computerized tomography (CT) scan or MRI.

Treatment options

Depending on the type of cancer and location, options may include chemotherapy (topical for anterior surface tumors, injectable about the eye, or systemic administration), cryotherapy (use of low temperatures), external beam radiation, radiation plaque therapy (also called brachytherapy), surgical excision of the tumor and enucleation (removal of the eye) or complete removal of the orbital structures. In the event of enucleation, Oculoplastics physicians or a tumor surgeon provide reconstructive surgery and prosthetic devices, tailored to each individual patient's case.

• Drug delivery systems: At Emory Eye Center, basic scientists and ophthalmologists are developing methods of introducing drugs directly into the eye to treat ocular tumors. Using a special gel, they have developed methods that can deliver drugs through the sclera that will be effective for as much as several weeks at a time. This technique may be used specifically for infants and children with retinoblastoma to deliver anti-cancer drugs directly to the tumor rather than infusing it through the bloodstream.
• Ocular Oncology Research: Ongoing basic science and clinical oncology research includes studying the pathobiology of eye melanoma, retinoblastoma, and orbital tumors. New treatments are being developed for these ophthalmic tumors based on basic science research, including new strategies for treating primary ocular melanoma, retinoblastoma and lymphoma.

Sisters take a short break from the crafts and games at the 2008 Emory Eye Center RB Day picnic held at W.D. Thompson Park in Decatur, Georgia.

The tenth annual RB Picnic , was held at WD Thompson Park in Decatur, Georgia on June 14. This very special event provided a day of fun and celebration for young patients and their families who have faced the formerly fatal childhood cancer of the eye called retinoblastoma (RB).

“In the Southeast, Emory offers the best possible care by providing the combined expertise of a highly skilled pediatric retina surgeon, Baker Hubbard, MD, along with an experienced pediatric oncologist, a radiation oncologist, a genetics counselor, and a host of consultants,” he says. “Using these approaches, the survival rate for retinoblastoma now exceeds 90%, and we are also saving more vision than ever before.”