Types of eye cancer

Melanoma starts in cells called melanocytes. These are cells in our skin, lips and the lining of organs such as the eye. They make and contain melanin, a pigment that gives colour to our skin and eyes.

Read more about melanoma of the skin

Melanoma of the eye can start in the:

• eyeball (globe)

• conjunctiva (covering of the front of the eyeball)

• eyelid

Uveal or choroidal melanoma

Melanoma starting in the eyeball is rare. Uveal melanoma is the most common type of eye cancer in adults.

The uvea is the middle layer of the eye and has 3 parts:

• iris (the coloured part)

• ciliary body

• choroid

Most uveal melanomas develop in the choroid part of the uvea. Your eye specialist may call this choroid melanoma. 

The rest of uveal melanomas begin in the iris and ciliary body. Iris melanomas are usually easy to spot, so doctors often diagnose them when they are in their early stages. They are usually slow growing and rarely spread to other parts of the body.

Read more about the different parts of the eye

Melanoma of the conjunctiva and eyelid

Melanoma of the conjunctiva and the eyelid are extraocular cancers and are extremely rare. Treatment for this is slightly different to uveal melanoma.

You usually have radiotherapy or surgery, or a combination of these to treat melanoma of the eyeball.

Read more about treatment for melanoma of the eye

Lymphoma usually begins in cells of the immune system called lymphocytes. These cells are found in the spleen, thymus, bone marrow and other parts of the body.

Lymphoma of the eye is divided into 2 groups:

• primary intraocular lymphoma 

• ocular adnexal lymphoma

Primary intraocular lymphoma

These develop inside the eyes. Primary intraocular lymphoma is rare. There are 2 types. The type depends on which layer of the inside of the eye is affected:

• vitreoretinal lymphoma

• choroidal lymphoma

You are more likely to have vitreoretinal lymphoma if you have a weakened immune system. For example, people who:

• have AIDS

• have had organ transplants and need to take drugs to damp down their immune system

• are aged 50 to 60

• have a history of brain lymphoma

Choroidal lymphoma is a lower grade lymphoma that can occur together with ocular adnexal lymphoma.

Read more about non-Hodgkin lymphoma

Ocular adnexal lymphoma

Some eye lymphomas develop in the tissue surrounding the eyes. These are called ocular adnexal lymphomas and are extremely rare. 

Primary intraocular lymphomas and ocular adnexal lymphoma are generally treated in the same way as lymphoma anywhere else in the body. Depending on the type and location of the lymphoma, they are treated with radiotherapy to the eye and chemotherapy. Other treatments may include immunotherapy.

There are two main types of cancers of the eyeball that develop in children. These are:

• retinoblastoma

• medulloepithelioma

Retinoblastoma

Retinoblastoma starts in the retina and most commonly affects children under the age of 5. This can be very distressing and frightening for the child and their parents. More than 90 out of 100 children (more than 90%) survive their cancer for 5 years or more.

Find out more about retinoblastoma

Medulloepithelioma

Medulloepithelioma is a very rare type of eye cancer that can develop in young children under the age of 10 years. It usually develops in the ciliary body and is generally slow growing.

Rarely, adults are diagnosed with this. This may be due to slow growing cancer that developed at a young age and was diagnosed later.

Symptoms include:

• changes in vision

• bulging of the eye

• pain around the eye

Treatment includes freezing therapy (cryotherapy), radiotherapy or surgery to remove the cancer. Sometimes it is necessary to remove the eye with cancer. This is usually when the cancer is more advanced. This operation will take some time to get used to. The specialists looking after your child will explain the operation and support you and your child through this.

Squamous cells are thin, flat cells and cover many surfaces in the body. Most squamous cell cancers are found in the skin. But they can develop in other parts of the body, including the eye.

Squamous cell cancer of the conjunctiva

The conjunctiva is the clear, moist membrane that covers the front of the eye and lines the inside of the eyelid. Although rare, squamous cell cancer is the most common cancer of the conjunctiva.

This cancer usually grows on the surface of the conjunctiva but can grow into and around the eye. It is generally slow growing (low grade), and very rarely spreads to other parts of the body.

Symptoms include:

• a red eye

• irritation around the eye

• a sensation of something in the eye

• a white painless growth on the surface of the eye

Treatment includes:

• surgery to remove the cancer

• freezing therapy (cryotherapy)

• chemotherapy eye drops (topical chemotherapy)

Conjunctival intraepithelial neoplasia (CIN)

Sometimes cells on the surface of the conjunctiva can look abnormal. These cell changes are called conjunctival intraepithelial neoplasia (CIN). They are usually diagnosed with a biopsy. You may have treatment with surgery or topical chemotherapy. 

CIN is a precancerous change. If left untreated, it may turn into invasive squamous cell cancer and may spread to other parts of the body.