Tumors in the eye usually are secondary tumors caused by cancers that have spread from other parts of the body, especially the breast, lung, bowel or prostate. Two types of primary tumors arise within the eye itself and are known as retinoblastoma in children and melanoma in adults.
Retinoblastoma is a cancer of the retina, the eye's light-sensitive tissue. This most common childhood eye cancer usually strikes children under age five, affecting 500 to 600 in the United States each year. In nearly a third of the cases, retinoblastoma occurs in both eyes. While symptoms are not evident early in the disease, increasing pain and vision loss eventually signal the problem.
Malignant melanoma occurs most frequently in adults 60 to 65 years of age, arising from uncontrolled growth of cells called melanocytes. From 1,500 to 2,000 new cases are diagnosed annually in the United States.
In addition to damaging vision, eye tumors can spread to the optic nerve, the brain and the rest of the body. Therefore, early diagnosis and treatment are extremely important. Melanoma tends to spread via blood vessels to distant organs. Wilmer ophthalmologists and other highly skilled physicians, like the pathologist, play a crucial role in making the precise diagnosis and in determining the progression of the tumor. Tumor cells are studied in the Wilmer Eye Pathology Laboratory, a world leader in diagnosing eye tumors. Physicians from the Johns Hopkins Melanoma Clinic are involved when their expertise is necessary.
For children, much of the diagnostic work takes place in what appears to be a playroom and involves techniques designed to be child-friendly.
There are various ways to treat eye tumors, depending on the diagnosis, size and aggressiveness of the tumor, and other factors. Certain small tumors may respond to laser treatment or freezing (cryosurgery). In some instances, it is possible to remove a tumor surgically and still preserve vision. A technique advanced by Wilmer researchers fine-tunes radiation therapy for eye tumors, focusing it more precisely on the eye. This minimizes the amount of radiation reaching healthy tissue. If the eye cancer is advanced and must be treated aggressively or removed, plastic surgeons at Wilmer perform reconstructive eye surgery. Today's artificial eyes or implants move almost normally and are virtually indistinguishable from natural eyes, although, of course, they do not see.
> Treated by the Division of Ocular Oncology
Researchers at Wilmer are studying hereditary patterns in childhood cancers of the eye. For families with a history of eye cancer, preventive measures and early detection programs can help alleviate some anxieties and minimize damage. For adult eye tumors, Wilmer researchers are conducting extensive clinical trials to see which treatments provide the best outcome. Simultaneous quality-of-life studies will show patients' preferences and which approaches yield the best function.