Eye cancer tests
This page is about the tests used to diagnose eye cancer. You can find the following information
Eye cancer tests
A doctor who specialises in diseases of the eye (an ophthalmologist) will examine your eyes to start with.
Diagnosing eye melanoma
If your ophthalmologist suspects you have an eye melanoma, they will refer you to a specialist centre for eye cancer. You will have various eye examinations there. You may have a test called a fluorescein angiogram. This means looking at blood vessels using a type of dye. You have an injection of the dye into your arm. It travels through your bloodstream to the blood vessels of the eye where it shows up on photographs. You usually also have an ultrasound scan of your eye. You may have blood tests to check your general health.
Diagnosing lymphoma of the eye
Your doctor will look at the jelly-like substance (vitreous fluid) that fills most of the inside of your eye to see if it is cloudy. To remove a sample of the fluid, your specialist will do an operation called a vitrectomy. This is done under local or general anaesthetic. Your specialist sends the sample of fluid to the lab for examination.
You can view and print the quick guides for all the pages in the diagnosing eye cancer section.
A doctor who specialises in diseases of the eye (an ophthalmologist) will examine your eyes to start with. If your ophthalmologist suspects you have an eye melanoma, they will refer you to a specialist centre for eye cancer. These are called ocular oncology centres. There are 4 in the UK, based in London, Sheffield, Glasgow and Liverpool.
You may have several tests to diagnose melanoma of the eye. These include
The ophthalmologist will examine your eyes with a number of different instruments. They will look at the different structures of your eye to check for abnormalities. They may put eye drops in to open up the pupils to make it easier to look at your eyes. The drops may sting a bit when they first go in. They will also temporarily affect your vision, so you shouldn't drive yourself home.
You will usually have an ultrasound of your eye. The doctor puts a clear gel onto your closed eyelid and then moves a small ultrasound probe over the skin. Or you may have a local anaesthetic drop into your eye. The doctor then puts an ultrasound probe gently onto the surface of your eye (the conjunctiva). This might be a little uncomfortable, but should not be painful.
Your doctor may take pictures of a suspected cancer with a special camera. This test is called a fluorescein angiogram. This means looking at blood vessels using a type of dye. You have an injection of the dye (called fluorescein) into your arm. The dye travels through your bloodstream to the blood vessels of the eye. The camera shows up the dye on photographs, which helps the doctor to find out more about the nature of any tumour.
Doctors rarely need to do a biopsy to diagnose melanoma of the eye, as they can usually do this accurately from the tests above. To have a fine needle biopsy, the doctor puts a thin needle into your eye. Using a syringe, they draw out some cells from the tumour. They send this sample to the lab to be looked at closely by a pathologist. You have this test done under local or general anaesthetic.
Although uncommon, there are possible complications from having a biopsy for eye melanoma, such as damage to the eye. Your doctor will weigh up the benefit of having the biopsy with any possible risks, and will discuss this with you.
If you have eye melanoma, your surgeon may ask a pathologist to examine the tumour after surgery for abnormalities of the chromosomes in the tumour cells. This is known as cytogenetic testing. It helps give doctors information about the chances of your cancer coming back or spreading. Your doctor or specialist nurse will talk to you about this and ask if you would like to know this type of information.
If you are not having surgery to remove your tumour, your doctor may now suggest having a biopsy of the tumour for cytogenetic testing. This is usually done during or shortly after radiotherapy. Your doctor will talk to you about the risks and benefits of having a biopsy.
Knowing how your cancer is likely to behave may help doctors plan your follow up care after treatment. For example, people at high risk of the cancer coming back may have more scans. At the moment, information about the genetics of your tumour doesn't affect what treatment you have. But it may in the future. There is information about this on our page about eye cancer research.
You may have blood tests to check your general health and see how well your liver and kidneys are working. Melanoma of the eye can spread to the liver. So you are likely to have an ultrasound scan of the liver to check for any cancer spread.
To diagnose lymphoma of the eye you may have
A doctor who specialises in diseases of the eye (an ophthalmologist) will examine your eyes to start with. An eye examination means your doctor will look at the jelly-like substance (vitreous fluid) that fills most of the inside of your eye to see if it is cloudy. Unlike melanoma of the eye, an eye examination will not give your doctor enough information to make a diagnosis of lymphoma of the eye.
Your specialist may want you to have an ultrasound scan or an MRI scan. These scans can help to show the size of a tumour and whether there are any swollen (enlarged) lymph nodes around the eye that may contain cancer cells.
Your specialist may want you to have a PET-CT scan. This is a combination of a PET scan and a CT scan. A PET-CT scan takes CT pictures of the structures of your body. At the same time, a mildly radioactive drug shows up areas of your body where the cells are more active than normal. The scanner combines both of these types of information. This allows your doctor to see any changes in the activity of cells and know exactly where the changes are happening.
You may have a PET-CT scan to check whether there are any cancer cells in the lymph nodes close to the eye or elsewhere in your body. We have detailed information about PET-CT scans.
To diagnose lymphoma, your eye specialist takes a sample of vitreous fluid from inside your eye. They do this during an operation called a vitrectomy. You have this under local or general anaesthetic. The doctor makes small cuts into your eye. Using some very small instruments, they then remove a sample of the vitreous fluid. They send this to the lab to be looked at by a pathologist for lymphoma cells.
Your doctor may suggest that you have a lumbar puncture. In this test, the doctor puts a thin needle into your back and removes a sample of the fluid that circulates around your brain and spinal cord (the cerebrospinal fluid or CSF). Your doctor may suggest this test to check whether any cancer cells have spread to the brain.
We have information about having a lumbar puncture.
After your tests for eye cancer, you may need to wait a while to get the results. Understandably, this is a very anxious time for most people.
While you are waiting for results it may help to talk to your specialist nurse, or a close friend or relative about how you are feeling. Or you may want to contact a cancer support group to talk to someone who has been through the same experiences.
Look at the eye cancer organisations page for organisations that can put you in touch with a support group. There are also details of organisations who can tell you more about counselling and help you to find sources of emotional support and counselling in your area.
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