DOSSIER Eye cancer, causes & treatments

As an organ, the eye is not immune to cancer. Its complexity means that malignant tumors can affect and take shape through several structures in the eye. Eye cancer, although it is rather rare, is not well known and, therefore, poorly detected. Faced with certain symptoms, it is advisable to be particularly vigilant. Certain behaviors can also promote it.

Through this file, we will try to find out more about eye cancer , its causes, and the ways to treat it.

Eye cancer: not one, but some

Malignant tumors of the eye can affect the entire makeup of the eye , including the eyelids, conjunctiva, orbit and its appendages, and the eye itself. While most are rare, they are quite serious and must be treated very quickly.

The most common eye cancer in adults is called uveal melanoma (or uveal melanoma). There are around 600 new cases annually in France. The tumor appears in melanocytes, the cells that make melanin, the pigment responsible for the color of the eyes , but also of the skin and hair. Ocular melanoma arises inside the eyeball.

As for symptoms, there are two main ones that should alert: the appearance of phosphenes (light signs always located in the same place) sometimes accompanied by black dots and the sudden drop in amplitude or visual field.

If taken on time, it can be treated with radiation therapy or brachytherapy . If it is too late to treat the tumor, then the eyeball can be removed. Finally, this cancer is likely to be the cause of metastases, often to the liver, which makes it particularly dangerous for other organs.

Another cancer that is a little less common but affects about 300 people per year is called intraocular lymphoma . Here too, a few warning signs should lead the patient to consult quickly. Especially when there is a gradual decline in visual acuity, and blurred vision, or redness or inflammation that lasts.

Treatment is possible and will depend on the diagnosis. This is because most often lymphoma is linked to brain lymphoma.

In children, there is an eye cancer called retinoblastoma . This cancer affects the cells of the retina. It only affects children, because the tumor attacks the retina when it is not fully formed. This is the reason why the vast majority of these cases concern children under 3 years old.

Camera screening!

There are around 50 children affected each year in France by retinoblastoma. In its bilateral form (if it affects both eyes), it is most often a genetic mutation. The latter can be inherited , and the parents can also present this same mutation.

If this is the case, a fundus of the eye should be done immediately after the birth of the child. But for lack of information, identifiable symptoms can be overlooked. Two of them are quite easily recognizable. These are early unilateral strabismus and leukocoria , which is a white or silvery reflection in the pupil.

If in doubt, it is possible to screen for leukocoria using a simple camera. Indeed, you have to take pictures from different angles, with a flash, and without activating any red-eye correction. If there is a red eye and an eye with a silvery reflection, it is necessary to consult.

Other, rarer tumors

More unrecognized tumors can affect the eye and its environment. Among them, eyelid tumors, which are actually basal cell carcinomas, that is to say the most common skin cancer. There is also the rarer and more aggressive squamous cell carcinoma , which can also affect the eyelids.

Finally, the orbit and conjunctiva can also be the subject of tumors, melanomas and lymphomas. All are quite rare but relatively serious. Therefore, early and appropriate management is essential.

Known risk factors for eye cancer …

Several factors make it possible to make the link with eye cancer. Age, in particular, is one of them. The average age of those diagnosed is 55 years old. Eye cancer is much rarer in children, although we have seen that some cases could exist, and in those over 70 years old.

The color of the skin and eyes are also proven risk factors. People with fair skin and light eyes are more likely to be affected than those with darker skin and eyes. There is no proven link, however, with sex. This cancer can affect both men and women.

There is some medical history that favors introcular melanoma. These are people who have experienced a nevus of Ota , hyperpigmentation of the eye or the skin around it. A Nevi , a congenital malformation of the skin, produced by excess pigmentation or dysplastic Nevus syndrome, moles of particular shape and color.

As we have seen, eye cancer can also be favored by a family history, and in particular by the mutation of the BAP1 gene. This mutation can also be the cause of other cancers, such as kidney cancer.

People infected with HIV are more likely to develop lymphoma of the eye and squamous cell carcinoma of the conjunctiva.

Finally, it should be noted that a trade is very risky. In fact, the welding profession offers an above-average risk of suffering from eye cancer, more particularly from intracocular melanoma . Ultraviolet exposure enhances it and this activity has been classified as a definite carcinogen for eye cancer.

… and suspected

Other behaviors, such as tanning, whether artificial or natural, are suspected of increasing the risk of certain eye cancers. Ultraviolet rays from tanning booths and sunlamps can damage the eyes and promote basal cell and squamous cell carcinomas. The rays of the sun, in the event of strong exposure, can entail an identical risk.

Finally, it has been discovered that certain industrial workers, subjected to exposure to products such as polychlorinated biphenyls (or PCBs) may have an increased risk of developing eye cancer. This could also be the case for aviation industry professionals , pilots and frontline cabin crew, who are exposed to high levels of ultraviolet radiation.

However, these conclusions remain to be confirmed.

Sources: Le Figaro , cancer-environnement.fr/